We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Steve Diamond made an interesting post last week describing the longstanding tension between the brain/behavioral and the mind/psychodynamic camps in psychology as a civil war. I have written here a number of times about this conflict, one that is at the heart of what is happening in psychiatry as well (if you are interested in the state of affairs in mental health, you really should read 1BoringOldMan who does a superb job of taking apart the trail of studies and inflated promises that got us here). I wish that what we are in were a civil war because then at least there would be active debate and engagement on these issues, but the takeover of psychology by the cognitive behavioral/brain folks is near complete on the academic level so that many younger clinicians have no idea of what is/was missing in their training. My side, the psychodynamic/mind side finds voice mostly through blogs like this one and those of other likeminded psychologists, psychoanalysts and psychiatrists. But together our voices are far less audible than those of the pharmaceutical and insurance companies and those of mental health professionals whose careers have been built on the effort to topple us. And the average person seeking help has no idea that these issues even exist. Yeah, it makes me kind of pessimistic at times.
I often feel that same way. Much of Psychiatric writing today has become so "medicalized," or "pseudo-medicalized," that you get the sense that it is check lists being treated rather than real people. Indeed, the two views of the patient - the hurting person - have developed different languages such that they cannot communicate well, and the alienation has become so extreme that I have heard them accuse eachother of malpractice.
Some of us attempt to straddle the divide, but it is difficult to rapidly alternate world-views.
So psychiatry encompasses both doctors and priests. Maybe the separation should be a little wider. Reminds me a bit of philosophy, where there is a separation between technical philosophy, which might be considered mathematics these days, and the humanistic branches.
Brain/Mind. A little absurd, really, that there are those who think they have that all figured out, either way. In my humble opinion, I figure we'll figure out the brain/mind knot about the same time we figure out faster than light transportation. Which, to me, makes some kind of sense. In the inner and outter kind of sense. Or something.
I have a schizophrenic relative for whom I've been responsible at times. When this relationship began Freudianism and other theories were still in vogue, and it was often assumed by professionals that therapy could control major brain diseases. This belief has gradually eroded, with good reason.
True enough, you can influence the mentally ill just as you can influence the "normal" mind by persuasion and the use of psychological techniques. But if your goal is control (because cures never occur at the present state of our knowledge) without constant monitoring, put your faith in drugs not therapy.
While there is much to be said in behalf of the positions taken by the "cognitive behavioral/brain folks" (see Dai Alanye's comments), my take is somewhat different.
I am and have been a Systems Analyst and see much of today's "therapy" as analogous to trying to fix a bad program by taking a hammer and chisel to the computer. Granted, this will stop bad behavior but it hardly fixes the problem.
Or, as a dear friend (who is a Psych Tech) recently said to one of her wards, "You do not have a disease, you're a Jerk!"
Schizophrenia can be considered analogous to other diseases. With a cold, a jerk or saint will simply become a cranky jerk or long-suffering saint. The cold has only an incidental effect upon basic personality or other mental traits such as intelligence.
Similarly, schizophrenia introduces an overlay of confusion upon jerk-ness or sainthood. Look upon it as random short circuits within the computer. The medications, with varying degrees of effectiveness, prevent many of the short circuits but also partially disable appropriate functioning of the computer, both slowing it and introducing dysfunctions.
A mild tendency toward schizophrenia results in a "creative" individual who can think outside normal boundaries. A complete lack of such a tendency makes for a person with "concrete" thinking. It's all part of a continuum, with those on the far right of the bell curve requiring institutionalizing and heavy medication. I know of no treatment for concrete thinking, however.