A New Vision for Mental Health
Source: A New Vision for Mental Health
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Islamist dictatorship in Turkey
Following the recent ‘coup attempt’, President Erdogan, who won the presidential election by virtue of his governing party taking state control of much of the Turkish media, is now moving to undermine the other essential pillars of democracy, most notably an independent judiciary.
More than 60,000 people have been detained, dismissed or suspended from their jobs. These include nearly 3,000 judges (many of whom will no doubt be replaced by Erdogan supporters), with 140 arrest warrants issued against members of Turkey’s Supreme Court and the vice-president of the Constitutional Court. And a formal ‘state of emergency’ has been declared, which allows the president and cabinet to bypass parliament when drafting new laws and to restrict or suspend rights and freedoms. Already it’s been decreed that people can be detained without trial for up to 30 days.
Meanwhile, Erdogan’s Islamist supporters have been out on the streets chanting “God is Great” … the ill-omened cry we’ve heard so often over the years from a range of Islamic fundamentalists in a variety of countries.
No doubt these supporters were encouraged some years earlier, when, prior to his becoming President (and three years before he became Prime Minister) Erdogan publicly read a nationalist poem including the lines:
“The mosques are our barracks, the domes our helmets, the minarets our bayonets and the faithful our soldiers.”
The ‘coup-attempt’ was highly (and suspiciously) convenient for Erdogan, giving him the excuse he’s been waiting for to further undermine and weaken his political opponents. The resultant purge has so far affected the police, schools, the judiciary, the armed forces and the provinces. Using lists that were clearly pre-prepared (the purge began instantaneously, well before any investigation could have possibly identified such extensive numbers of people), nearly 3,000 judges have been suspended, whilst 6,000 members of the military (including more than 100 generals and admirals) were arrested and more than 3,000 dismissed. Around 8,000 police officers have been sacked, along with nearly 9,000 interior ministry staff and some provincial governors.
Parts of the media – those that were not already under state control – are also being targeted. So far, 142 media outlets have been shut down, including 16 TV channels, 23 radio stations, 45 newspapers, 29 publishers, 15 magazines and 3 news agencies. Detention warrants Larbeen issued for 89 journalists and reporters.
The ‘purge’ goes further still. More than 1,200 associations have been shut down, along with 19 trade unions and 35 medical institutes. Even more ominously, the government has closed 19 universities and more than 1,000 schools. It has also suspended over 15,000 education staff, with more than 1,500 university deans ordered to resign and the licences revoked of 21,000 teachers working at private institutions.
All in all we may justifiably surmise that what is essentially happening is the arrest, dismissal or suspension of those known to be (or suspected of being) politically opposed to Erdogan. No doubt there are more detentions and dismissals to come. Suddenly, in today’s Turkey, political opposition to the government is edging towards being branded a crime.
It’s obvious that Erdogan is a man who doesn’t believe in ruling on behalf of all the Turkish people, but only on behalf of those who (supposedly) elected him as President. In this he makes the most fundamental mistake of all concerning democracy, believing it instead to be a battle for the right to supress those who ‘lost’ the election.
Meanwhile he sits in his new presidential palace – bigger than the White House or the Kremlin and costing many hundreds of millions of pounds – and contemplates bringing back the death penalty.
Looking at the wider picture, Turkey can no longer be considered anything even close to being a reliable member of NATO – and indeed is now in serious breach of one of NATO’s stated fundamental objectives, namely to promote democratic values. And the prospect of Turkey being allowed to join the European Union is now further away than ever – decades away at least.
The sad truth is that it’s now unlikely that any truly democratic election will ever be permitted in Turkey whilst Erdogan and his fellow Islamists remain in power: state control of the media and other agencies vital for democracy will see to that.
So unfortunately, and unless the liberal and secular peoples of Turkey can somehow oust Erdogan from power, Turkey will continue its rapid slide towards an Islamic dictatorship.
Psychiatry: a failed profession?
Psychiatry: its origins, how it became threatened and its response:
Psychiatrists are doctors of medicine who have undergone additional, specialist training.
The path towards establishing psychiatry as a mainstream profession effectively began with Sigmund Freud, a medical doctor who famously developed psychoanalysis as a means to help some of his patients. This ‘talking treatment’ approach included the exploration of dream-symbolism and the unconscious self, a focus on repressed (unconscious) sexual desires (e.g. the ‘Oedipus complex’) and the use of free association … where the patient talks freely, without censorship or inhibition, about whatever ideas or memories occur to them. Within this approach, anxiety and depression (for example) were seen not as symptoms of disease, but instead as emotional distress arising from internal psychological conflicts.
The psychiatrists who followed in Freud’s footsteps keenly adopted psychoanalytic theory, partly because it hugely expanded their potential ‘customer base’ beyond the asylums, opening the way for the treatment of patients in private practice.
As the 20th century wore on, however, the effectiveness of psychoanalysis was scrutinised and increasingly criticised … to the point where psychiatry as a reputable profession came under serious threat, partly because of problems over diagnostic ‘fuzziness’, and also because of the rise of counselling[1] as a rival form of talking treatment offered by practitioners who didn’t need to have medical doctorates.
In an effort to protect their guild interests – and to safeguard the very survival of psychiatry – the profession switched direction. It enthusiastically adopted a ‘disease model’ for mental ill-health, a model that fitted well with the medical background of the doctors involved. And with this new model, the treatment of patients became increasingly centred on prescription drugs.
So began the development of an institutionally-corrupt financial relationship with the pharmaceutical industry. And so also began psychiatry’s journey down a deeply unscientific path.
Psychiatry as pseudo-science:
The American psychiatric ‘bible’ is the Diagnostic and Statistical Manual (DSM) of Mental Disorders (equivalent diagnostic manuals exist in Europe and elsewhere). The first DSM edition, published in 1952, contained 106 categories of supposed mental disorder, including homosexuality as a “sociopathic personality disturbance.”
Fast forward sixty odd years: the recently published 5th edition (DSM-5) now lists well over 600 categories of supposed mental disorder … a nearly six-fold increase compared to the 1st edition. This is, of course, excellent news for the business and commercial interests of both the psychiatric profession and the pharmaceutical companies.
Thus, egged on by vested commercial and guild interests, almost every type and incidence of emotional, personal and ‘mental’ problem or distress has been turned into a ‘disorder’ or ‘illness’ or ‘syndrome’ or similar type of stigma – to be treated (of course) mostly by means of prescribed drugs.
In what way has this process been driven by pseudo-science? In what way is the bio-physical ‘disease model’ adopted by psychiatry so profoundly flawed? The main answer is simple: after all this time, after decades of research, there is still a complete absence of any biological markers for – and biogenetic causes of – ‘mental’ ill-health.[2]
Take, for example, some of the more severe forms of ‘mental’ ill-health. Dr. Lucy Johnstone (a psychologist) has written:
“We have known for a long time that terms such as ‘schizophrenia’ are scientifically meaningless. They are not actually ‘diagnoses’ in a medical sense, since they are not based on patterns of bodily symptoms or signs. Instead, the criteria consist of a ragbag of social judgements about people’s thoughts, feelings and behaviour. The people who are so labelled may well have difficulties and be in urgent need of help, but this is not the way to help them.”[3]
Or, for further instance, take so-called Attention Deficit Hyperactivity Disorder (ADHD). As one of the more enlightened psychiatrists, Dr. Sami Timimi, has written:
“ADHD is … ideally placed as a convenient diagnostic ‘dumping ground’ allowing all of us (parents, teachers, doctors, politicians) to avoid the messy business of understanding human relationships and institutions and their difficulties.’[4]
Or as John Shlien, Professor of Education & Counselling Psychology at Harvard University, has written:
“Diagnosis is not good, not even neutral, but bad. Let’s be straightforward and flat out about it, it is not only that its predictions are flawed, faulty and detrimental to the relationship and the client’s self-determination; it is simply a form of evil. It labels and subjugates people in a ways that are difficult to contradict or escape.”
The good news, however, is that the crisis of psychiatry has now reached the point where even the authors of diagnostic manuals are starting to finally admit that psychiatric diagnoses are not supported by evidence.
So where to now?
The reform of ‘mental’ healthcare is a vast subject and contains many needed elements (not least, under the heading of ‘prevention’, a priority focus on children and young people – see here, for example, ‘Bad Education’). But we can identify at least three of the main strands without further ado.
- Recognise that ‘mental’ healthcare is largely misnamed. The real focus should be emotional healthcare … because emotions (e.g. depression, anxiety, fear, guilt etc.) are the core experiences of most so-called ‘mental’ health problems.
- Abandon the disease/medical model and replace it with a contextual approach in which problems do not exist in isolation, but arise from, and are connected to, each person’s unique self, life story and life circumstances. Instead of asking people ‘what is wrong with you?’, we should instead ask ‘what has happened to you?
- Hugely reduce the emphasis on drug-treatments (treatments which stem largely from the misconceived disease/medical model) … and hugely increase the provision of counselling services.
The upshot of these is that psychiatry, as a profession, becomes largely redundant … at least in anything even remotely resembling its current form.
Of course the majority of psychiatrists – and the drug companies whose profits thus become threatened – will loudly protest. But when it comes to emotional healthcare, the truth is that the majority of doctors do not know best.
[1] A profession effectively begun by Carl Rogers in the 1940s.
[2] As used here at least, the term ‘mental ill-health’ does not include conditions – such as dementia – that are caused by bio-physical factors and involve a loss of brain function (e.g. memory).
[3] Dr. Lucy Johnstone, www.madinamerica.com 2013.
[4] Dr. Sami Timimi, Making and Breaking Children’s Lives, PCCS Books.
Trumperites
The supporters of Donald Trump are venting their anger at a Republican party “establishment” which they feel has consistently let them down and betrayed them. But in supporting Trump they show no understanding that the Republican leadership has mostly been forced to “betray” them because the causes that they espouse find little echo amongst the wider electorate and are thus heavy political liabilities when it comes to electing a president.
Yet Trumperites live in denial, persisting with the delusion that they are the “silent majority”.
But hey, here’s some breaking news for such folk: in reality you are nothing but a loud, aggressive and unpleasant minority. And in truth the American people will never elect Trump – or anyone like him – to the office of President … because they know that such bigoted blowhards are quite simply not fit for office.
So go ahead, support the ignorance, bluster and deliberate outrageousness of Trump. Cheer his racist comments. Clap heartily as he continues to hurl insults left, right and centre. Stamp your feet in approval as Trump makes ridiculous, ill-informed, abusive comments and proposes absurd and impossible policies – building a wall along the entire Mexican border being just one of the less outlandish.
And enjoy your fifteen minutes of exultation as you effectively destroy the Republican Party from within … because you’ll have another 4 long years in the wilderness to reflect on your blinkered stupidity when Hillary Clinton is sworn into office roughly a year from now.
One day, Republican supporters will come to understand that bible-thumping doesn’t cut it, that homophobia isn’t popular, that focusing narrowly on anti-abortion campaigns simply alienates most women, and that bashing Muslims and Hispanics merely loses them most of the Muslim and Hispanic vote.
One day Republican supporters will come to understand that the politics of hate, bigotry and division don’t win presidential elections in the 21st century.
One day ….
Spiral Scribbles 