Sam,
There is an article in the March 2002 Scientific American entitled Scars
That Won't Heal: The Neurobiology of Child Abuse. It's author Martin Teicher
concludes with:
"Society reaps what it sows in the way it nurtures its children. Stress
sculpts the brain to exhibit various antisocial, though adaptive, behaviors.
Whether it comes in the form of physical, emotional or sexual trauma or
through exposure to warfare, famine or pestilence, stress can set off a
ripple of hormonal changes that permanently wire a child's brain to cope
with a malevolent world. through this chain of events, violence and abuse
pass from generation to generation as well as from one society to the next.
Our stark conclusion is tht we see the need to do much more to ensure that
child abuse does not happen in the first place, because once these key brain
alterations occur, there may be no going back."
Curiously, while reading through the DSM-IV Guidebook p4 I came upon the
following. After describing how Hippocrates utilized the philosophical and
scientific method of Aristotle for classification, it reads:
"Plato, a near contemporary of Hippocrates, had a radically different
philosophical approach to classification. He maintained that the
unchangeable really resided in universal ideas rather than in the individual
objects of our senses. In the *Phaedrus*, he classified "madness" (mania)
based on his conceptualizations of its ideal form or underlying nature.
Plato first distinguished "madness given us by divine gift" from that which
is the consequence of physical disease."
I think he had it right. There are folks who are socially different. To
assess whether they have a "divine gift" might be through asking if the
activities/thoughts of the person have greater dynamic quality. A clear
example where this is not the case is someone endangering themselves or
others. Folks like this are out there as well, and how we label them is
immaterial (and labels can be counterproductive) - they are in need of
intervention. And it seems to me consideration of organic origins should not
be ruled out. That these may change as a result of idea/social intervention
should not be ruled out either, but we best not blanketly assume this method
can always be effective. I certainly agree that prescribing drugs is done
far too much where other methods would be healthier.
Treating mental illness in a religious context can be dangerous because you
are basing it on static moral codes that have basis in humanity's strugle
with the mystic. The MOQ may be no different here, but it at least points
towards higher quality in general, whereas the moral codes you set forth can
be more limited, certainly when they are misapplied. In your example, to
label Charlotte a sinner is not much different than labeling someone as
being mentally ill. This doesn't mean that Charlotte's activities were not
low quality. She probably had higher quality choices, like having this man
confront his low quality marriage so that his wife and he both are better
supported, and confronting her own intent before contributing to the
marriage's ending. But perhaps her activity saved the man from a sooner
death, or provided each of them greater joy. Maybe she was the brujo - how
do we assess?
Ed
----- Original Message -----
From: "Elizaphanian" <Elizaphanian@btinternet.com>
To: <moq_discuss@moq.org>
Sent: Thursday, May 02, 2002 3:41 PM
Subject: MD Mental illness
Hi Platt,
You said:
> Freud's Ego
> and Superego battles with the childish Id as the cause of adult
> psychological problems has been largely proven false by the discovery
> of biological base of mental illness.
I think you need to be a bit more careful about this. Whilst I have no
problem with rejecting mainstream Freud, I do not think that the scientific
claim that there is a 'biological base of mental illness' can be supported.
In fact I'm a bit surprised that you buy into it as thoroughly as that
sentence would imply. When Pirsig/Phaedrus was locked up, was that because
something had gone wrong with his biology? Moreover, it seems to be in flat
contradiction of some of the MoQ insights (differentiating biological,
social and intellectual levels). How should a brujo-like figure be judged?
Who is to judge what counts as mental illness in any case? For all those
illnesses (eg Parkinsons, Alzheimers) where a biological basis has been
established, they are no longer counted as 'mental illnesses' in the same
way as, say schizophrenia, for the very reason that an organic level cause
has been found. It is only where an organic basis has *not* been established
that we have the language of mental illness at all. Are you familiar with
Tomas Szasz's work on this? There's quite a bit about him available on the
net if you're not familiar with it.
Below is a discussion paper I wrote last year for a school-group discussion
(kids aged about 17) on a similar theme (I do some part-time chaplaining in
the school as part of my job, so I was acting explicitly as a religious
minister in the discussion). You might find it interesting. Although I tend
not to use MoQ language, you can see where SOM thinking is being objected
to.
Sam
TWO LANGUAGES
“Behold, I set before you this day a blessing and a curse: the blessing, if
you obey the commandments of the Lord your God, which I command you this
day, and the curse, if you do not obey the commandments of the Lord your
God, but turn aside….” (the book of Deuteronomy, 11.26-28)
“Do not fear those who kill the body but cannot kill the soul; rather fear
Him who can destroy both soul and body in hell…” (The Gospel of St. Matthew
10.28)
I would like to discuss today a few things relating to religion and mental
illness. As you might imagine, I am speaking from a specifically Christian
perspective, but I would expect that similar points might be made by an
Islamic teacher. I am going to criticise something called the ‘medical model
’ of understanding mental illness, and argue that a religious understanding
is both more accurate, and more therapeutic. However, I should say at the
outset that my perspective is NOT mainstream, and I would recommend that in
any examinations that you may have to sit, that you provide mainstream
answers. This sort of perspective might gain an extra mark or two if you
mention it, but I wouldn’t recommend spending a great deal of time
developing this line of argument. However, if in your own life – and nearly
one in five women are diagnosed as mentally ill at some point in their life,
in this country – you or someone you care about is diagnosed as suffering
from ‘mental illness’ I think that you may find it helpful to have a look at
these notes…
Medical illness is quite well understood. A person is ill when their body is
malfunctioning in some identifiable way – either there is some visible,
external problem, eg a broken leg, or there is an invisible, internal
problem, eg a virus or cancer, which can nevertheless be discerned through
tests or X-rays or similar. In each instance, there is something observable
which is independent of the social context of the individual being treated.
For example, if a person has cancer, then that cancer will develop in
certain particular, well understood ways, and the cancer will develop in the
same way whether the person is living in London, West Africa or India.
In contemporary Western society, medicine has advanced significantly through
the application of the scientific method. Put briefly, the scientific method
depends upon the distancing of personal opinions from the subject being
studied – this is why you will sometimes hear the claim that science is
‘objective’ and ‘value free’ – and an investigation of the mechanical
processes which underlie our physical existence. So, in medicine, we have a
very good understanding of the cardio-vascular system (our heart and lungs)
and how they operate, and they operate on very clear physical principles.
So, with bodily illness, medicine has very effective means of studying the
problems, and developing solutions. Put differently, we might say that it is
appropriate to study the break down of normal bodily functioning in this
way. The way in which bodily malfunctioning is understood is called the
‘medical model’.
Let us now consider what it means to be mentally ill. There is something
called DSM-III which lists what is counted as a mental illness (this is
used specifically for schizophrenia):
Delusions (considered bizarre, grandiose, absurd etc)
“Deterioration from a previous level of functioning…”
social isolation or withdrawal, impairment in role functioning, impairment
in personal hygiene or grooming…
“blunted, flat or inappropriate affect” (affect = emotional response)
(Note at this point, that these are markedly NOT independent of the social
context.)
Where a person is displaying these characteristics then they are now classed
as being ‘mentally ill’ and placed into psychiatric care. Mental illness is
understood by the psychiatric profession to be a similar sort of disorder to
bodily illness, except that – and this is the punchline – the causes of the
disorder are not understood. Where they are (eg where they can be traced to
a specific bodily disorder, such as a virus (encephalitis), or Parkinson’s
disease) then they are no longer considered a ‘mental illness’ in the same
way, and the method of treatment changes.
Where possible, the psychiatric staff will treat the patient through the use
of psycho-active drugs, which either serve to change or stabilise the mood
of the person, or to dampen the intellectual energy of the person. In this
way the ‘symptoms’ of the ‘illness’ can be treated, and the psychiatric
profession can continue to research further methods of treatment with the
hope that they will eventually discern the underlying cause of the ‘illness’
and then be able to cure it.
It is my view that this approach is fundamentally flawed, from both a
philosophical and religious perspective, and that there is no such thing as
‘mental illness’.
I mentioned earlier that the classifications used to assess whether a person
is or is not mentally ill are closely tied in with the social context,
specifically, with what a particular society considers to be acceptable
behaviour. To take the example of ‘hearing voices in the head’ – in some
societies this is seen as evidence of divine favour, and the person
concerned is given a respected role as an oracle of God. In other societies
it is seen as evidence of possession by demons, and the person concerned is
executed. In either case – and in our own society – the classification of
the person is determined by what the society accepts as ‘normal’ or
‘abnormal’. This is a decision made by the society, and as such it is
subject to questions of morality and ethics – and therefore religion.
I began this paper with a quotation from Jesus. When Jesus talks about the
soul, the word used (in the Greek) is ψυχή – psyche, from which we get our
word psychology, which means the understanding of the soul. In western
society, the way in which the symptoms currently described as mental illness
were treated were through a religious understanding – the person concerned
was not right with God. This way of understanding psychology was dominant
for two thousand years and forms part of the core of how priests are
trained. As you might imagine, it reached quite a sophisticated level,
before being supplanted by modern scientific methods. This was not a step
forward.
I mentioned earlier that bodily illness functions independently of social
context, and that science studies it through distancing the personal
opinions of the person doing the studying. Neither of these factors is
appropriate for the symptoms listed on the DSM list.
It may be easiest to put across the difference by considering a particular
example. Imagine a woman – let us call her Charlotte – who has an affair
with a married man. The man leaves his first wife and marries Charlotte. Six
months after their marriage, the man dies suddenly. Charlotte becomes
depressed. She no longer functions properly within her various social roles,
and is not able to maintain her job. She stops looking after herself and
becomes emotionally numb. And so on. Charlotte goes to her doctor, and the
doctor prescribes a course of anti-depressants, which lift her mood and she
returns to her job.
>From the perspective of medial science, all that can be done to help
Charlotte has been done, and in fact she has been returned to her work so
clearly the treatment has been successful. From a religious point of view,
this is a disaster.
To begin with, a priest would consider it natural for a person to go through
a period of mourning after the death of a loved one, and that the change in
behaviour manifested would not need any further explanation. One of the
problems faced in our society is that we are not allowed to be unhappy –
happiness has become an idol, and therefore suffering has to be suppressed.
This is self-defeating.
Secondly, the language which a priest would use about Charlotte would
include words such as ‘shock’, ‘grief’, and ‘guilt’. Charlotte has received
a shock, and is not able to come to terms with what has happened. A priest
would interpret this by looking at the story of her life up to this point,
and in particular at the affair. This is a sin – a breach in human
relationships and a breach in the relationship with God. And, bearing in
mind the quotation from Deuteronomy, if there is sin, then the life will be
blighted – hence the depression. The way forward for the priest would be to
talk through the story and establish whether Charlotte had any
unacknowledged guilt etc which could then be confessed and absolved. The
desired outcome would be for Charlotte to flourish once more – without the
help of drugs.
In essence, the language used to describe the phenomena which people
display, listed in the DSM criteria, is radically different between
psychiatry and religion. They are in effect two different languages,
attempting to describe the same phenomena. My perspective is that the
religious language is both more accurate and more humane, and that it is
more likely to lead to healing.
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