This has been the change in the last 20-30 years of psychiatry:
listening to the 'delusion'.
Madness as a concept comes with disregard of the validity of the
experience, i.e. "mad" is associated with being wrong or of less respect
in someway or fashion. The content of communication by mad people was
disregarded by psychiatry historically and in general practice. Few,
lone outspoken fools (my language) stood against the curve to say that
there was humanity to madness and though the list is long the consensus
social and medical reality continued in a dismissive "the guys a loony"
framework with a degree of facile understanding about madness: it was
excusable drivel caused by brain illness, but drivel none the less and
to be treated as such. I admit that this used to be my opinion when I
was young and lacking insight.
The assumption was that madness was a form of delirum or demenita
(though not in the modern clinical sense of dementia) and the content
was ridiculous, absurd, insane, etc - all the terms that allow a
person's opinion or experience to be dismissed.
A significant shift was the change to making a genuine effort to listen
to the communication of the mad, and to listen to their madness. The
advocacy movement was a significant part of this however the goals of
the movement became lost when it became mainstream. As with all real
progress the ideals of the 'fundamentalist', 'progressive' or the
radical become made acceptable or palatable.
Change is made by the idealist but the ideals are butchered, e.g. the
right to an advocate as stipulated by the MHA 1983 (2007 amendments) is
not the same as people going through extremem crisis not being listened
to, treated with dignity and humanity, respected as a human being and
not degraded to a sub-human medico-legal description of "lacking
capacity" loosely based on a poor tool to make an assessment (?Gilick
competence test?) or the ideology of the significant figures in various
religions is often bastardised for any tyrant (or saints) purposes'.
This is simply the path of change. Don't pathologise it.
Any waym the point (and aggressive criticalness aside aside) divides
into two parts: the listening to the voice of the mad and the asking of
the mad (and those that attempt to help) to listen to the madness. The
former is fucking huge, the latter is beyond hyperbole and expressive
expletives. The latter, i.e. the change against psychopathologisation
and dismissal of the experience of unshared perceptions (or simply the
reacceptance of madness as a normal human experience) and the acceptance
of the possibility by the medical model of the spirituo-biopsyhcosocial
model is a shift in society's consensus normals akin or greater to the
changes in expectations of gender, sexuality, race and religion (and other).
It's fucking huge is what I'm saying. It's one of those changes no one
could have predicted. It's a welcome one. It's hope, in a world of
fucking shit.
The spirituo-biopsyhcosocial model is the one I've had the most
difficulty writing about and my admission is that it's a personal
failure. Another post perhaps?
No comments:
Post a Comment