There are simple reasons why we have not solved, and might never solve, problems in mental health and substance abuse. But it might be possible to solve these problems, if we can honestly and creatively confront the reasons we have failed to do so. I count three reasons:
First, we erroneously believe insanity is brain disease.
Second, we mistakenly think we can manage people like animals.
Third, we confuse help and control.
Insanity is not brain disease. If you want to use medical metaphors just to prevent the careless exclusion of doctors who are so insecure about their social value anymore, you could probably say it's moral disease or moral atrophy or moral disorder, or something like that.
More fundamentally, insanity is just a compulsion or constant intention to stop or destroy (anything and everything). Anyone who kills or enslaves another human being is insane. Actually, anyone who knowingly commits or omits actions to cause more harm than good is insane, at least for the time it takes to do that. The fact behind this is the basic goodness of the individual. People naturally try very hard not to commit crimes or hurt others, because they are good. When they become obsessed with stopping and destroying, they are not being themselves, but have (covertly, unconsciously) "chosen" at some point to solve an overwhelming confusion by being a synthetic, evil entity.
But the bottom line is, even if brain disease can cause a convincing appearance of insanity, insanity itself remains a decision to be evil or stop and destroy things in response to an unsolvable confusion. When psychiatrists fiddle with brain chemistry they are more likely to create insanity than to cure it.
People cannot be managed like animals. This is mostly because people are almost always smarter than animals, and they usually like each other more than they like most animals. People have (human) animal bodies, of course. But they sometimes consider that their integrity to themselves is more important than their bodies, and that their self-determinism and honor are more important than their immediate lives. It is doubtful that non-human animals indulge in the luxury of such considerations very often, if ever.
The whole psychological model of "the human animal" was a philosophy of political control, which bucked up against ancient and much better understanding, beginning really as late as the Nineteenth Century. With the advent of the modern state, life became complex and leaders like Bismarck needed to become more extreme. Apparently in response to the confusion of modernity, when there were suddenly over a billion human beings for the first time, and complex machines became powerful enough to transform life, the idea that man is merely an animal made a good excuse for killing as many people as necessary to maintain "order."
Such "order" ultimately manifested in 1945: 30 million war dead, social and economic ruin, true existential threat to our whole species and all life on Earth.
The curious little error which, in my view, ties the psychiatric idea that insanity is brain disease together with the fundamental psychological concept of man-as-mere-animal... is the failure to distinguish help and control. Both are legitimate activities of society. Every good person wants to help others and is pleased to be helped by others. But it seems that accepting control from others and exerting control over others come less easily for most of us.
Thus, when we are faced with a necessary task of control, we wish it were really a helping project, and we pretend. If we should control a crazy person so they don't hurt themselves or others or destroy things, we call it "treatment" (help), and we say if the person doesn't want our help, it's because their animal brain is defective. The truth is, we are afraid to tell the crazy person, "You are making us nervous so we are going to control you now." So instead, we lie and say, "You need to take this medicine to help balance the chemicals in your brain."
(NEXT: A three-point plan to solve it all!)
This is not mental health care, it is mental sickcare,, their only aim is to keep people sick to keep the money rolling in.
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