The Mind and the Moon

#BrainComplexity

He remembered being in medical school, forty-odd years ago, and professors predicting imminent, precisely tailored cures for cancer. “And cancer is so dumbass simple compared with disorders of the brain. We were so naïve.”

#PsychiatryCritique #Foucault #Laing #Szasz

Three of the most consequential thinkers of the 1960s and ’70s, the philosopher Michel Foucault and the psychiatrists R. D. Laing and Thomas Szasz, attacked the very foundations of the profession. They argued that the diagnosis of mental illness was based on nothing objective, that it depended completely on culturally determined definitions, boundaries, norms. Foucault taught that psychiatry’s claims to rationality and specialized knowledge were inherently deceitful, that they were a means to stigmatize, quarantine, and subdue those who think with originality, those whose visions might disrupt the prevailing social order

#Alternatives #Lifestyle

Nestler and I turned to broader topics, to our society’s overreliance, he said, on psychotropic drugs, to our reflexive seeking of medication to salve our emotions, and to the psychiatric profession’s reflexive writing of prescriptions. “Unquestionably,” he said, about whether fewer Americans should be on psychotropics for depression and anxiety. “We could do with much less medication.” ... Then he went on: “Exercise. Better sleep. Mindfulness. The belief in something bigger than yourself. Religion if you’re religious.”

#SpectrumNotLabels

A misleading formulation put forward in 1980 by the DSM-III. In their desperation to establish psychiatry as a medical science, the framers had promoted a way of thinking about diagnosis that was categorical, definitive. A patient either did or didn’t meet the checklist threshold for a disorder. Diagnostic boundaries were much overemphasized; the idea that we might all exist along psychological spectrums was pushed aside. This still had a deceptive resonance that hindered the quest for understanding.

#Tyranny #GoodIntentions

She relied on C. S. Lewis for wisdom: “Of all the tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive.”

#Music #Memory

Alzheimer’s patients who no longer recognize or remember their closest family still know the lyrics and melodies of songs that moved them when they were young.

#Humility #Listening

We don’t know. Perhaps these three words should be psychiatry’s mantra. Perhaps this might take us to a new beginning, marked by a new humility and enabling a new depth of listening and communication, for the profession and for ourselves. Perhaps by breathing and repeating We don’t know, we might overcome some of our fears and understand one another more profoundly.