Psychiatry Among the Sciences
I do. But I reserve my hopes in psychiatry for those
clinicians who undertake the trust each individual puts before them in good
faith. I admire psychiatrists with interest in the full scope and picture of each
in their care. They see and hear, even feel, what each person tells before administering
treatments for symptoms, treatments they recognize as limited in many ways, and
so they apply them with care and great regard for effects both positive and
negative.
When I’m watching documentaries about discovering the
universe, over time how people have sought to understand the sun, moon, stars,
and Earth’s place, ranging from assigning them godlike qualities, through
gradually realizing in committed, repetitive observation that all these rotate,
then that Earth is not the center, risking heresy to say so, yet maintaining
their course of further learning, I think of psychiatry. I evaluate psychiatry as
a science, its origins, and where it might go. Astronomy advanced immensely
with the invention of the telescope, with rockets into space, computers,
theories, theories, theories, and the never-ending drive to prove or disprove
them. We have space programs, stations, satellites, shuttles, roving science
stations on Mars, probes headed as far as we can take them on fuel and
gravitational pull.
Psychiatry isn’t awarded the big budgets of NASA or entrepreneurial
billionaires. But, like those exploring space, researchers stare into the vast,
varied human experience, and then look closely into the tiniest recesses of the
brain, neurons, cells, just as space explorers contemplate the huge unknown of
the universe unfolding while searching for signs of life in slices of sediment under
a microscope.
Psychiatry needs to be given its time, its chance to take
risks, its opportunity to test theories.
When there is desire to examine a planet further from Earth
more closely, the process starts with proposals and presentations, then a
contract is awarded with budget constraints, and the engineers,
astrophysicists, chemists, the whole team begin work to achieve the goal. They
don’t know exactly how. It takes years and it takes sending out more proposals
to solve problems within the primary proposal. Budgets expand. They don’t entirely know if the
end product will work. They don’t know how factors in space might affect their
best laid, highly calculated plans. They don’t know, and yet, one day, at 3-2-1
blast off! -the experiment roars up into the sky and away on its mission.
Amazingly, because humans have built on the earliest of
observations and theories and have used technologies as they become available,
we’ve come to learn so much more, photographing, sampling, letting people live
in space, getting closer with improved telescopes and having patience to send
probes so far that they may not reach their destination before the scientists
retire.
It’s awe-inspiring, quite beautiful, and the stuff of
dramatic, heart-pounding movies.
Psychiatry rarely does that for the general population, even
though it involves the very heart and soul of each and every one of us. If central
nervous system imaging came at us in high definition and spectacular color as
regularly as Hubble and Webb space telescope images, would we find it just as
fascinating?
I think about if psychiatric research had access to a
facility as grand as say, The Brookhaven Large Hadron Collider. Maybe with that
kind of funding dedication to neuropsychiatric research, we could figure out better
how brain chemicals really react or what causes disparities in human behavior.
It’s a touchy subject, though, isn’t it? People don’t
necessarily want to be broken down into just their biology and then fixed with
dystopian-sounding chemical interventions or, god forbid, insertion of probes
or computer chips. We want our distress to lessen, even cease, but not in the
sense that we are under control or could be controlled.
I support psychiatry, ethical, caring, and kind psychiatry,
because it’s a frontier with so much possibility.
I hate parts of where it’s at now, all the involuntary or
coercive aspects to treatment, the coldness of institutions so able to hide cruelty
and abuse, the randomness at times of how patients are drugged, over drugged,
drugged for too long, without help available for safe withdrawing or damage
from treatment, the liberal and frequent use of electroconvulsive therapy (ECT)
because a hospital has it available and nobody’s keeping score, and the idea
that drugging people and then asking them to participate in behavior modification
training is in any sense humanitarian.
But I take note of the psychiatrists who want to move beyond
the way psychiatric care is now, who are doing their best and helping people
with the tools they have now, who continue to assert that psychiatry is valid
and who continue to prove and disprove theories, even as they don’t know if
best laid plans will land right, or even bring a discovery they didn’t
anticipate.
Valid, you say? I must relent, after considering my own self
and my four decades in psych treatment, after witnessing for myself the plight
of so, so many fellow patients, that yes, there is validity to certain parts. I’ve
seen people way out of it, stuck inside another world and time, self-care
impossible, who respond to a drug and there was no other way they could be
brought out, not that is currently available. I’ve also seen people, not as bad
off as that, who desire help because they live in despair or chaos, and they
want what psychiatry has to offer. I’ve also traced patterns in my biological
family, and if I clear the generational trauma to one side, there remains a
cluster of deep depression, illnesses that are just exhaustion, true manic
states, and delusional thinking. This pulls me toward some sort of, call it
what you like…disease, disorder, malady…that is passed genetically. But there’s
no certainty, just observation, in that little theory of mine.
I’d like a future where ongoing generations, instead of denigrating,
handwringing over, or casting out its family members suffering in the throes of
mental torment or just looking like…a loser…would be able to find an accurate
diagnosis, a fully understood treatment, and care that encompasses the whole of
the individual, mostly keeping them in the community.
