Text: Kendall Pfeffer
Photography: Henry Stanislaw
This article is the first part of the Mental Health series by Kendall Pfeffer.
Part two: The Freedom of a Mutable Mind
Once upon a time, a man named Walter Freeman had a mission to rid the world of mental illness. He dedicated his life to aid those who suffered from depression and schizophrenia. Very noble goal, you might say. He also happens to be one of the most notorious doctors of the last century. This same man performed over 3,000 lobotomies by inserting a sharp metal tool under his patients’ eyelids and into their brains.
Now, it is easy for us to look back on the days of lobotomies, as archaic, barbaric, exceedingly cruel, and seemingly far, far away from the present. But we ought to be more observant of our own times. What will our ancestors view in the current methods of therapy and treatment as primitive, out-dated, possibly even savage? We do not have all the answers, so we ought not to accept the current consensuses as givens.
There always seem to be en vogue treatments and en vogue diagnoses. During the 60s and 70s schizophrenia was particularly popular among researchers. Bi-polar and manic-depressive disorders had their day in the limelight. And now anxiety disorders and attention deficit disorders seem to be a particular focus. Clinical depression typically remains pretty high on the totem pole of interest. So why do these disorders seem to be more or less “popular” in specific periods? Is this because they reflect the focus of current study, of new research discoveries in the field, of common interests? Or because they represent a certain malady of society; inadequacies, pressures, impossible demands that are unique to the culture at specific periods of time and are reflected in the mental health of the general populace? Is our contemporary cultural experience eliciting particular, harmful mental habits and producing specific, maladaptive modes of mental processing as we attempt to adapt to the ever changing landscape of the human world?
It becomes necessary to note that the tenets held within the field of psychology rarely originate from a wholly objective position. In addition, our classifications tend to stagnate, to deceive our understanding by feigning infallibility. But we must remember that life does not stagnate. It is always moving and changing, a fluid force, and so are our minds. Hence, the inveterate theories of today, our orthodox systems of thought, our particular angle of approach and mode of analysis should give when life pushes and pulls against our rigidity.
While I by no means intend to question the validity of psychology, I think an appropriate awareness of its limitations is necessary. The field of psychology is both very young, just reaching its adolescence in comparison with other fields of science and humanities, and has traditionally dealt exclusively with theory and areas testable only outside a laboratory. Somewhere along the way (I would guess it was somewhere about the time when the increased efficacy of new medications met with the genetic-based understanding of mental predisposition), we seem to have lost touch with this reality.
But let’s be clear. Diagnoses of mental disorders are based upon theory; theory is always subject to improvement or change. Drug treatments are very often guesswork, happened upon by accident or years of laboratory testing.
One particular theory has classified manic-depressive or bipolar disorders as a permanent disease which will follow one their whole life, with medication being the only efficient cure. However, recent research at the University of Missouri provides evidence which may thwart this understanding. The research suggests that bipolar disorder which is detected at an earlier age, between 18 and 25 years, may be outgrown by the time the patient reaches 30. The onset of bipolar at a younger age could be a reflection of the difficult transitions faced
Another example of this continual process of uprooting accepted psychiatric treatment is the very tentative nature of drug prescription for particular mental disorders. The term, drug cocktails, has arisen to describe the guesswork of applying several different drugs to treat the more complex disorders. A recent article on WebMD acknowledges that ‘mixing drugs is still more art than science’. Often these drugs aren’t designated exclusively for specific mental illnesses. They can be effective in various treatments because they react differently in different people. And this is something which cannot be predicted to any positive degree as of yet. It seems ironic that in this case the scientific-based approach is less systematic than the psychological approach.
Prescription drugs, even when taken according to doctor’s recommendations, can be very dangerous as well as possessing an amazing potential to alleviate suffering and distortion. We ought to proceed with caution. Psychiatric drugs exist very much within a realm of trial and error. The popular antidepressant Nortriptyline, for example, has recently been associated with an increase of suicidal thoughts among its users. It is hard to imagine being faced with a crueler reality than the discovery that a drug which is meant to ease the torment of depression is actually pushing you further towards the brink.
My point here is that we are not discussing a realm of absolute truth or scientific certainty. The fields of psychology and psychiatry are not infallible. Their theories are proposed by people and people have the tendency to be wrong or to only catch a glimpse of the much bigger picture. Like all human construction, the field of psychology follows the ebb and flow of professional as well as popular opinion. The angle of approach and the motivations for research shift. We should treat its pronouncements, even its vocabulary, according to what they are – transitory and speculative, tentative at best.
Also read: The Freedom of a Mutable Mind
Kendall Pfeffer is American and studies at the University of St Andrews in Scotland.