We’re fortunate on the one hand to live in a culture with such an advanced medical system, however, the medical establishment’s territorial claims over many mental health issues as well as other conditions such as addiction have DECREASED the likelihood of the general public receiving the appropriate treatment and help for those conditions.
I’m unsure how the territorial infringements first began. I think it began because the mental health field was younger and beginning development in the early part of the century and it desperately wanted recognition from the medical establishment. One of the ways it received recognition from the medical establishment was to mirror the medical establishments structure of diagnosis and treatment. In other words if you have a skin condition, the diagnosis that you receive means everything in terms of the proper treatment being delivered. However, the mental health field is a trickier matter. I may treat several patients with the same “disorder” from different points of view and each of them demand that I do so insofar as they each have a unique life history, personality, and resiliency. Therefore, diagnosis points in a certain direction with treatment and is important and sometimes crucial in working with mental health patients, but the link between the diagnosis and treatment is vague, and there will never be a pill for every possible variety of neurosis.
I’ve met with several families who have been victimized by the biological determinism overpowering the mental health field currently. Most of them have received a diagnosis from a primary care physician when the child is young and the parents and doctor together have from that point on approached that child’s condition as if it is a simple matter of cause (a broken brain) and effect (misbehavior or other mental health symptoms). Most of these parents are disillusioned to realize that after years of dispensing psychotropic medication to their child, they have not come any closer to treating the underlying structure of the condition. If they return to the doctor or psychiatrist to complain, they are often prescribed additional medication and/or diagnoses without deepening their understanding of the nature of their child’s condition.
Don’t get me wrong, I am not one who disbelieves in the efficacy of all psychotropic medication. It is especially beneficial to those with Bipolar disorder and Schizophrenia and not particularly helpful for the other 498 mental health conditions listed in the diagnostic and statistical manual for mental health disorders. And even for those with psychotic disorders such as Bipolar and Schizophrenia medication alone is not enough to treat the condition nor enough to adequately understand the etiology of the symptoms.
What you are not going to hear on Oprah is that the brain and environment are a two-way street. The mental health field is in an era that currently distorts the complexity and interactivity of nature versus nurture when it comes to understanding a variety of mental health conditions and addictions. Understanding mental health symptoms cannot be reduced to thinking that “a broken brain is causing broken behavior” in a linear one-directional manner. Certainly the brain is affected by and sometimes structurally changed by mental health conditions, however, the environment is a powerful, powerful force in having shaped those changes and is also a powerful force in offering hope to change the so-called “broken brain”.
Psychotherapy and specifically psychoanalysis are major agents of change with mental health conditions that are underappreciated in their power and effectiveness to promote healing. They are not in vogue right now because these methods are expensive, time-consuming, slow, confusing, and sometimes provoke immense pain in the healing process. However, our field and the patient are losing out on something immensely helpful to their suffering, and ultimately something that will re-wire the brain — from the inside out.
