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Streetlight Effect

10/5/2013

 
It has been dubbed the “bible” of psychiatry, and indeed the Diagnostic and Statistical Manual of Mental Disorders (DSM) is taken by many as exactly that. Every new version of this publication, prepared by the American Psychiatric Association, is considered to contain the latest and more advanced criteria for the classification and diagnosis of mental disorders.

Acceptance has not been unanimous, though. For many of its critics, the DSM has been too unreliable, far too prescriptive and yet quite vague, very much geared towards the compartmentalization of human behaviour, very much conforming to the wishes of the big Pharmaceutical companies –in short: very problematic.

The news, then, that after more than sixty years of near hegemony –at least in the U.S.– the DSM is pushed aside by the US National Institute of Mental Health (NIMH), cannot but be welcome. A research framework is being introduced for collecting data for a new understanding of mental disorders, a "new nosology", away from DSM.

Is there, at last, room for optimism? Are we finally about to enter an era of scientific psychiatry which will (hopefully) settle all disagreements and clear out all ambiguities for good?


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Trapped Inside

24/11/2009

 
This is the sort of things you see in films or read in novels –"Johnny Took his Gun" by Dalton Trumbo or "The Patient" by Georges Simenon are but two of the examples that spring to mind– but the report that circulates all media since yesterday is very real. A paralysed Belgian man who doctors thought was in coma for 23 years was conscious all along. It was only recently that a scan showed that his brain was "almost entirely" functioning. You can read the BBC report here.

I cannot begin to grasp what it must have been this experience for this poor man, but I can very vaguely imagine. A recent book and film used the metaphor of a diving bell. You are inside your body as if you are inside a diving bell. It's alright when you can control your diving bell. You swim around and interact with all other beings in diving bells you encounter. Suddenly something happens and you loose control of the diving bell. Your life as such is not threatened; but you can't communicate any more, you can't interact. You are trapped inside.

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The “stigma” of therapy

23/9/2009

 
In my latest post I wrote about how people who see that you are a therapist take it for granted that you deal with mentally ill people. I realize that this association between therapy and mental illness is not rare and goes both ways. If you are in therapy yourself many people seem to automatically believe that you are mentally impaired in some way.

Ask yourself. Imagine that you were in some kind of distress and asked your best friend for some kind of advice. What would you think if they told you that you need to see some a specialist, a psychotherapist perhaps?

Many people would take offence. They would protest that they are not ill, and cut the conversation short. If their best friend was like them, they would back down immediately and would try to suggest something else.

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Nothing to cure

17/9/2009

 
People ask me sometimes what I do for a living, and when I tell them, almost invariably I am met with a look of understanding and compassion. I know what this look says. It says: “Poor you, for having to have such a regular contact with those mentally ill people.”

In the early days I tried to challenge this view. (I don’t anymore).

I would explain that people who go to a psychotherapist or a psychoanalyst are not necessarily mentally ill. I would admit that some of them might be, of course, but even they, I would stress, do not go to the therapist because of their illness. They might think so, but what they really do is go to the therapist because they need help and hopefully the therapist can provide this.

This very simple truth was incomprehensible to many of my interlocutors –and, I would expect, to many of the readers of this blog. I can almost hear, loud, the objections: “If you cannot cure people, why do you invite them to come to you? Is this a joke or something?”

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    About

    This is the blog of
    Christos Tombras
    a psychoanalyst practising
    in North West London.

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