Tuesday 8 November 2011

What is mental health? Choice.

I've described different continua. Now I should be writing about weirdness. Being different. Hard to understand. Abnormal and mentally healthy. Another dark topic and concept built into this uberconcept termed mental health and illness.

But I'm not going to. I'm going to go off on one about choice. Mental health and human liberty are not bedfellows.

Drapteomania is the famous example of mental health and its relationship to things which doctors should not be part of. This is the psychiatric diagnosis given to black slaves who kept on running away.

Much could be said about this diagnosis. I'm going to peer at it looking at the element of free will and what the paradigm of illness means.

A black slave who repeatedly ran away was considered insane. White psychiatrists at the time couldn't understand this behaviour. It needed to be dealt with too. Thus a person who runs away from their slave life is mentally ill. Their free choice is their illness as equally as their behaviour and actions become as the judgements of psychiatry take hold.

A black slave who keeps on running away doesn't get to chose their life, not once the label of mental illness is applied. They can chose many other things in life but the psychiatric system will treat them to stop them running away. Their treatment is to make their free will in line with the expectations of normal slaves.

Slaves who were lazy were also diagnosed as mentally ill. Treatment boosts their productivity. This is the same as modern arguements used by Lord Layard for improving access to psychological therapies for depression and anxiety.

The power of labelling as an illness means it must be treated away, and this is all backed by the authority and respectability of the medical profession.

The public far too easily forget or never even hear of diagnoses like negritude. Negritude is the medical illness all Africans had. It's what made them black. Treatment was to turn their skin colour white.

Skin colour is not a choice but behaviour, emotion, experience of consciousness and other facets of the human condition are often about choices.

The medicalisation of homosexuality and arguments about whether patients who are gay but want to be treated should be allowed to be treated or deemed mentally ill. They're examples of how choice is dismissed using the application of the label of mental illness.

This is nothing to do with science. Science is used to give authority to psychiatric dogma but it is pseudoscience when it is applied by psychiatrists.

I see individual choice and psychiatry's power in a similar way to the Church's power before the Industrial Revolution. Religion layed down rules of behaviour and emotion and choice. It also gave explanations and treatments or punishments based on the symptoms and the label. Sinner, witch, etc.

Priests were where people went to solve their life problems and misery. Their truth was the truth of god's word. Now the truth of science is misued by psychiatrists and therapists to replace the role of religion in the post-Industrial Age.

The treatments are generally more humane than some of those used before psychiatry's inception though they're about as effective in high quality, placebo controlled trials. Even electro-convulsive therapy is only as good as the sham treatment on followup.

In one regard they're doing the same thing as religion did. The system is used to overcome choices. One last example to further elucidate the point is that of unmarried mothers.

Unmarried mothers at the turn of the 20th century could be locked up and have their children taken away because they were mentally ill. Their only symptom was being poor and being an unmarried mother. It was often 'repeat offenders' who were incarcerated even though being an unmarried mother was not a crime. The wealthy might be able to support their child but those that couldn't could face the same punishment of a label of mental illness.

The justifications and the prcesses leading to the inception of a psychiatric diagnosis are as complex as the workings of the Vatican. Once they've been established psychiatric science goes about justifying the existence of the diagnosis using modern psychiatric techniques. The public and patients, in the main, then assume that it's all true until history shows it not to be.

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"