Sunday, October 31, 2021

Futile Journey, from Freud to "All Brain Disease"

Former psychiatric slaves lately freed from Illinois' iconic plantation at Elgin Mental Health Center recall with irony that a certain K Unit clinician had a bobble-head Sigmund Freud doll on her desk. Freud is of course a significant figure in the history of psychiatry. He is also significantly conflicted, variously respected or renounced, for many reasons.

In the second quarter of the 20th Century, Freud's influence was at its height; but by the 1960's, American psychiatry was hoping to become a real medical specialty. Although Freud himself always thought of psychoanalysis as a medical enterprise, his libido theory, along with the several complexes named after Greek drama or unmentionable body parts, were just too weird and disrelated from common experience. (Not everybody really wants to kill his father and have sex with his mother.)

On the other hand, the one contribution for which Freud is usually credited is the notion that sexuality is pretty central to human relationships and human experience.

Lo and behold, modern psychiatry in its mad rush to become medicine had to renounce all consideration of sexuality in the new view, wherein all mental illness is simply brain disease. Psychiatrists had to be brain doctors, not soul doctors, since after all, souls don't exist. In 1980 when DSM-III was published, this was an over-obvious marketing decision. If they could cure psychosis with antipsychotic drugs, why should they continue to embarrass themselves by talking about anal obsessions or Oedipus complexes? 

But in fact the brain disease hypothesis was weak enough scientifically, that it had to be insisted upon as a strict article of faith. In this context we might explain certain, otherwise-inexplicable aspects of the culture inside the Illinois Department of Human Services' forensic psychiatric institutions.

Elgin Mental Health Center is not a hospital, where people go voluntarily hoping for relief from suffering through effective medical treatments. Rather, individuals are sent there, being essentially sold into psychiatric slavery by criminal court judges and state's attorneys who just don't have the stomach to punish them for the criminal acts they admit they committed. 

Given this actual nature of the institution, we might adapt the point recently made by Charles M. Blow in the New York Times: It is not possible to truthfully portray American slavery without depictions of sexual violence; likewise, sexual abuse of people institutionalized under a cynical guise of psychiatric "treatment" will always be absolutely endemic, as the staff on K Unit at Elgin Mental Health Center have convincingly proven.... 

The rules about appropriate "boundaries" between staff and patients would actually seem overly strict or even draconian to most laypeople, and the protocols for enforcing those rules are amazingly voluminous. As with laws and bureaucratic policies generally, the more complex prohibitions become in a particular subject area, the more it can be suspected that behavior violating underlying ethical principles must be widespread. 

Involuntary "patients" at Elgin are supposed to be medically helped... to recover from mental/emotional/behavioral problems which were arbitrarily designated, forty years ago by a vote at the American Psychiatric Association, as discrete "mental disorders". Unfortunately the 1960's hope for neuro-psychiatric discovery of causes, and advances in treatment, just never did pan out. 

Now, the strict medical model for such help, with no outmoded Freudian attention to sex, nor even any personal relationship with a therapist, is a looming problem. Any day, the taxpaying public might realize that paying a high premium for psychiatric "hospitalization" of miscreants instead of prison... is a major ripoff.

And that one M.D. psychiatrist on K Unit, with her bobble-head Freud and her faux shock over how such a thing as sex on her unit could have ever happened... just doesn't help, at all!

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