Wednesday, July 28, 2010

The Psychiatric Box

All boxes have four sides. These are the sides of the Psychiatric Box.

1. The soon to be psychiatrized one, shows distress and claims someone, or a group, or something, is doing him/her some kind of harm. Either the individual in distress or someone else, on that one's behalf, contacts a psychiatrist for help.

2. The psychiatrist appears to listen to the patient's distress but not for too long. Often now, ten to fifteen minutes is seen as sufficient time for a “diagnosis.” It is a 'diagnosis' of the individual who sits before the psychiatrist which is the aim of the assessment. The soon to be psychiatrized does not really understand that this discussion about his/her problems is NOT being taken at face value, but rather is being heard from inside the psychiatrist's pre-programmed mind as signs and symbols of 'mental illness' which is directly equated by today's psychiatric profession with “brain disease.” The patient is now under what we call ‘the clinical gaze’ and is being treated as an object of observation and not an equal human being. The psychiatrist of course does not share this perspective on the patient with the patient. That would be too equal. It is a 'secret' relationship he is having, mostly with himself, and is often very much like one that brought the patient to the psychiatrist's office in the first place.

3. The psychiatrist decides, often in ten to fifteen cost effective minutes ,whether s/he does, or does not, believe the patient's understanding of 'reality' is valid and comes up with a diagnostic label which reflects the psychiatrist's beliefs according to what s/he has been taught to understand in the psychiatric training. The patient is often told the diagnosis, but not always. If the patient then says, but I am not sick (at least not 'sick’ in the terms psychiatry is defining it as a 'brain disease' and/or 'chemical imbalance,' the psychiatrist is most likely to hear the denial of the diagnosis as a sign of 'illness' in the patient, who is then said to be 'in denial' or ‘lacking insight’ into his/her own 'illness.' The diagnostic label itself is sometimes heard later, as a sort of psychiatric “surprise” of which the patient was not informed at all. Once labelled though, the label tends to stick like glue with most people who are informed of it, even if new ones are later applied instead or as well as, the original one.

4. Whether the patient yet realizes it or not, s/he is now boxed in to the mental illness system's inescapable parameters for after this point, no matter WHAT s/he says or does, it has all been written beforehand and identified as 'symptoms' of mental illness proving how right the system is for taking over the life of the patient. This may well complete the psychiatry tautology then (the circle so often understood by the patient only AFTER s/he is trapped) and is often a repeat performance of the relationship problems with another in a relationship outside the system. Ironically then the psychiatrist, and the problem person(s) or situation, that brought the patient there in the first place, is now dominating the patient's life even more than before s/he arrived for the 'help.’ Now the patient knows there is no way out except to try to convince the ' doctor,' another psychiatrist in control, or often a whole endless series of them, that the original complaint that brought the patient there is actually valid and that the diagnosis is not.

Thus begins the patient's lifetime career as a 'mental patient' with incarceration, drugging by force, eye rolling, sighing, and, if the patient is non compliant, perhaps shock treatment to get rid of those 'delusions' about being harmed by ‘others.’ All the patient's relationships (whatever may be left of them ) will now change to accommodate the expert diagnosis. Group pressure will be applied with intimidation tactics, behaviorist tactics, threats, and psychological isolation used to get the patient to co-operate with what is now a group agenda. The patient is now alone with his/her truth.

The only choice left after that is adopt the reality which has been defined FOR the patient by others, or pretend to believe it, just so that those others, who can never be blamed will not offer anymore unwanted 'help.' Or perhaps one may choose to fight on, usually alone, trying to penetrate the group resistance to the truth.
Now though, we are not all as alone as we once were for now we can connect better to others who have been though the same kind of thing, and many of us have made it back out of this group madness, a little worse for wear perhaps, but in one piece.

There is hope but it is going to come from those of us who can see it and understand it better and NOT from the experts who cannot hear a word we say because they are so well trained to define it all in terms of an alternate reality which really is like 'talking to aliens' to most of us.

We cannot help but wonder if we are really from the same planet as the psychiatrists who cannot hear a word we say as REAL.

As I once said of one of my own doctors after pondering the odd notion that I could not have been ‘set up’ or ‘harmed’ by another as it would not have been ‘reasonable’ for ‘others’ to behave that way, “What planet have you people been living on?”


Anonymous said...

You forgot the top and bottom of a box/cube, five (bottom)and six (top)sides. Mark p.s. just joking

Patricia said...


This box is different because I am actually standing on the floor and with the four sides surrounding me and the top of it is SO high that I can't reach there smarty! ha hya