Posted by Oddzilla on August 24, 2000, at 15:53:29
I just ran across this outstanding article and thought it deserved to be read here. It certainly provides food for thought!!! Do you know this guy Dr. Bob? It said he was from Chicago!!
Oddzilla
Psychiatric Medications as Symptoms
February, 1997
by David Kaiser, M.D.
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A middle-aged woman with a long history of chronic depression came to see me. She was taking Serzone at appropriate doses, and had experienced some improvement. At this visit she complained of frequently feeling angry. She felt her anger was extreme, and was caused by a "chemical imbalance," because "this much anger is not normal." It was obvious to me while talking with this educated and thoughtful woman, that she was experiencing rage toward a number of others, past and present. When I told her the anger was a reaction to people in her life and that she could use this anger to understand herself better, she remained unconvinced, saying she felt out of control and needed some kind medication for it. She was neither violent, nor out of control. She left unsatisfied and angry, as I did not change her medications.
For this patient, as in all patients, the medication she wanted functioned in her mind as a signifier. In other words, it had a meaning above and beyond its actual effect. For her, a medication represented perhaps a soothing other, a containing other, a form of love, a magical erasure of the past, or many other possible meanings. Only in speaking with her could this be elucidated. In my experience the signifying effect of medication is often more powerful than its real effect. Patients form complex and intense attachments to their medications more because of what they mean than what they do. This is why psychiatric patients often get on and stay on medications, often several at once, even though their actual benefit is questionable. All psychiatrists can relate to the experience of attempting to change medications in patients who are attached to them and resistant to change. Any change threatens some precarious equilibrium related to a complex set of meanings that their medications have taken on.Another way of saying this is psychiatric medications often become symptoms, in the sense of symptoms as signs full of meanings which function to cover over or fill in some lack in a person's life-whether it is a lack of love, desire, purpose or whatever. The psychiatrist, as the dispenser of these medications, is often acting to reinforce the patient's symptoms, further covering up of the patient's ability to see the true source of their discontent or unhappiness. As a result patients often need medications in the way they need their symptoms, as a substitute for what they really need from people. Medications lessen their pain, help them forget, provide a kind of substitute for love, and these substitutes are all the more powerful because they are sanctioned by modern medicine, authority and technology. So it is possible for modern biological psychiatrists to unwittingly act out symptoms and fantasies with their patients, leaving them more alienated from themselves and more dependent on false forms of gratification.
The true dimensions of this technologic catastrophe has yet to be learned. Today's patients, discontented, unhappy, fragmented and confused by an increasingly frantic, alienating and violent society, come to psychiatrists for help, only to have their illusions shored up by an increased dose of a technologic fix. They are told they have illnesses that are biologic and can be fixed, instead of being allowed to speak about their unhappiness, to speak about how difficult it is to be a human being, to speak about their suffering, because human beings have always suffered and always will. To believe that we can conquer depression, despair, anxiety with modern technology is the height of hubris and bad faith, a mere childish fantasy, unworthy of any thoughtful person who has their eyes open to human history and modern culture. Psychiatrists have become part of the problem. Perhaps they have always been so.
I can already hear the objections. Modern science is beyond such considerations, beyond good and evil, to coin a phrase of someone who knew better. We will go beyond subjectivity, which psychoanalysis depended on, to reach an objective science of human unhappiness. There is an epidemic of "depression," which is a medical illness, and we will stalk it and wipe it out like smallpox, given time, science and public health measures. Everyone with this illness called depression should be on medications. A bit of Zoloft in the water supply perhaps. Then we will all be content and productive. If I satirize here, it is only to bring out the absurdity of what is actually happening. An epidemic of depression? How about an epidemic of cozy relationships between academic psychiatry, pharmaceutical companies and managed care companies? How about an epidemic of psychiatrists who no longer think seriously about what suffering is? How about an epidemic of psychiatrists more interested in power and social legitimacy than in listening to their patients?
As a practicing psychiatrist, I often feel the pull of a patient's symptoms, a pull in fact to participate with them to cover up what is really going on. It is a seduction which should be resisted, because it is a seduction to enact a fantasy. Modern psychiatrists have been seduced wholesale, not only by patient's wishes, which are fantasies, but also by positivistic science and technology, which are as much based on fantasy. But it is a measure of how far this has gone that these words will seem extreme to today's psychiatrists, caught up as they are in multiple illusions, increasingly blind to the truth.
Please direct any questions or comments to Dr. Kaiser at Mental Health InfoSource.
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Dr. Kaiser is in private practice in Chicago, and is affiliated with Northwestern University Hospital.--------------------------------------------------------------------------------
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thread:43647
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