Scientism and Sacraments

Opened hands offering assorted multicolored pills and capsules. Close up.

Most modern professionals in the mental-health system are idealogical materialists. They operate from a reductionist/materialist understanding of persons. The medications they prescribe for mental health conditions are not curing the “disease” (implying a biological origin). Antidepressants and antipsychotics are minor tranquilizers – they do not alter brain chemistry, they only produce calming (and often psychologically deadening) effects, which may be somewhat helpful.

Roger Scruton describes science overreaching its perimeters—becoming scientism.

Attributing depression to brain chemistry falls within the perimeters of overreach and is reminiscent of another ill-formed but timely “science” now proved bogus — phrenology.

Dr_Spurzheim_phrenology

Assigning emotional, sensory and spiritual experiences to biological processes in the brain, based upon what researchers presently know about the brain, is tantamount to inter-cranial physiognomy.

PhrenologyHead-lores

Psychiatry is a multibillion dollar industry that frequently violates the autonomy and dignity of those it seeks to “cure”.

There are several researchers and many former psychiatric patients who are seeking to inform medical consumers on the true nature of this sham science. Please see the work of Dr. David Healy. His book Pharmageddon is especially good.

Medications that are marketed as changing the brain chemistry of patients with a diagnosis of depression, bipolar disorder or schizophrenia do no such thing; they are merely minor tranquilizers. Such drugs may provide a level of sedation that is helpful to the person taking them but often, of more practical import is the power these drugs have to quell behavior that others find disturbing.

Psychiatric researcher, Joanna Moncrieff addresses these issues.

Psychiatrist Gary Greenberg writes thoughtfully on the treatment of depression in Manufacturing Depression: The Secret History of a Modern Disease and critiques the American Psychological Association’s Diagnostic and Statistical Manual in The Book of Woe: The DSM and the Unmaking of Psychiatry.

Thomas Szas writes on the unfortunate history of psychiatry in Coercion as Cure: A Critical History of Psychiatry, among other books.

Robert Whitaker has written several helpful books, Mad in America is a good introduction. Mr. Whitaker’s site, Mad in America provides a wealth of resources for those in the grips of Big Psyche and Big Pharma.

Dr. Ben Goldacre exposed the bogus nature and corruption of much psychiatric drug research in Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients.

Stuart A. Kirk and his fellow authors address psychiatric coercion in Mad Science: Psychiatric Coercion, Diagnosis and Drugs.

Hearing Voices Network presents alternative ways to think about hearing voices for those who experience voices, visions and other related experiences but do not want to resort to the psychologically and spiritually deadening and often physically harmful effects of psychiatric drugs.

A friend told me about her recent visit to chronic fatigue support group. She was looking for tips on chronic disease management. However tips were not be found, the group was a forum to discuss medication. Many in the group members offered themselves as research subjects in clinical trials. Some were taking as many as 8 different psychoactive medications.

In our secularized age we are not truly secular we have just transferred our faith and allegiances from priests to a new kind of intermediary; doctors now take on the roles of priests and psychoactive drugs are the new sacraments.

Insights from Robert Orsi in Thank You, Saint Jude (p. 144-147)

American medicine was itself entering a new moment in its history, by the 1920s, physicians, in alliance with educators, muckrakers, and progressive politicians, were finally successful in their long campaign to eliminate alternative and competing practitioners from healing work. By setting and enforcing new national standards for medical training, hospital accreditation, and professional advancement, and by sharply restricting the flow of information about healing techniques and drugs to the lay public, these activists discredited the many nonmedical healers popular in the United States a group that included midwives, chiropractors, chiropodists, osteopaths, folk and faith healers) and curtailed what had once been a widespread culture of self-treatment. One healing paradigm—the biomedical—and one very well organized and supervised caste of healers would now dominate medical care in this country. These changes were not simply imposed from on high, however. A convergence of factors—new attitudes toward marriage, family and children that emphasize bonds of love and nurture; the challenge of the progressive and labor movements to the harsher consequences of capitalism; and improved standards of living—made people want better health and happier lives for themselves. By the late 1920s Americans of all social classes were anxiously identifying an ever expanding range of symptoms as needing medical attention; expecting more from their healers, they began to yield more authority to the men from whom they wanted so much.

nurse at home

A major transition in the ecology of healing accompanied these shifts. There were fewer than two hundred hospitals in the United States in 1873, according to a government survey; by 1920 the number stood at six thousand. The newer hospitals were awesome citadels of technology and science, located outside the ordinary settings of most people’s everyday lives. This move to the hospital further deepened the social distance between doctor and patient and enhanced the latter’s authority. As hospital care was increasingly restricted to the acute cases. Furthermore, ‘the boundary between staff and patients in hospitals, one crossed by convalescents and the less seriously ill, now became more fixed,’ in medical historian Paul Starr’s words. A critic of the modern hospital was already complaining by 1907 that the patients had been reduced to the status of a “medical subject” a lament that would grow louder and more insistent over the next sixty years.

sickbed doctors

The consolidation of medical healers’ power and prestige and relocation of care had tremendous consequences for the construction and experience of illness. Sick people and their families came to rely primarily on doctors to define the nature of their distress and its appropriate treatment, mistrusting their own judgments and inclinations in the complex intimidating and mysterious works of modern scientific medicine. It became almost impossible for patients to challenge doctor’s judgments or to know when to ‘disengage’ from them in Starr’s word. Exchanges between physicians and patients were radically unequal, reflecting divergent levels of education, social class, access to power and prestige; patients were in awe of their doctors. Nurses, once independent of doctors and able to question sickroom decisions, were gathered under the institutional authority of hospitals and effectively silenced. Professional codes of conduct limited even what doctors might say about the methods and choices of their colleagues; it was only in the 1970s that physicians began to acknowledge a legal and moral responsibility to discuss alternative procedures with their patients.

The awe inspired by the modern doctor had varied sources, but the most important was his powers of diagnosis: identifying disease was what physicians did before most of this century. Tools like the stethoscope, introduced in the mid 1880s and later X-rays and biomedical laboratory science enabled physicians, most  of the time, to tell patients exactly what was wrong with them.

img_xrayhand

Diagnostic skill contributed to the medical mystique creating what Starr calls an ‘asymmetry of information’: patients could see that their doctors knew more about the insides of their own bodies than they did. This had several implications for the lived experience of sickness. First, as diagnostic technology improved, the actual speaking voice of the patient became increasingly otiose. Physicians dreamed of devices that would free them for patients’ unreliable (as they saw it) descriptions of their own distress; as such tools become available the rift between doctor and patient widened. The medical consultation slowly waned in importance as patients’ idiosyncratic descriptions (and medically useful) emotional, cultural and moral detail and understanding, became irrelevant. Diagnostic virtuosity limited the range of acceptable discourse in medical settings by narrowing the meaning of “illness” to what registered on a meter or appeared in laboratory tests. Anything else that patients had to say about their experience – the story they wanted and needed to tell—was defined out of bounds.

Second, the priority of diagnoses contributed to the geographical displacement of sickness, as patients waited in one place for the results of tests made in another to come back form a third before setting out to be taken by car from one specialist to still another. Medical practice in this century was steadily severed from its local connections, a development analogous to the broader eclipse of the local…   The sites of discernment and healing moved from the sickroom at home to the hospital and then to the laboratories and clinics beyond; medical news good and bad now came from afar.

Finally, and very important for understanding Jude’s place in modern medical history, diagnostic sophistication altered the temporal, as well as the spacial, experience of sickness. The future became the dominant tense of sick time. Sick people waited anxiously for the results of tests and – once these arrived from the laboratory out there – they had a clearer sense of their destinies than ever before. The questions sick people had for their physicians were oriented toward the future: When will I get better? When will the pain go away? When can I leave the hospital? Prognoses became a popular obsession, the lay complement to medical diagnostic virtuosity.

Patients and their families believed their doctors could answer these questions. They also expected that the men who could so accurately tell them what was wrong with them could do something about it. But the fact of American medicine until the Second World War was that doctors could not cure what they could so skillfully identify. Until the arrival of wonder drugs after the war, the hopes raised by diagnostic acumen were most often dashed. This is not to say that doctors could not bring relief to their patients, but it is an irony of this history that what comfort and help they could provide depended precisely on those features of the doctor/patient relationship that were being eclipsed by the increasingly narrow scientific orientation and institutional structures of modern medicine—conversation, trust, familiarity, touching, being present in the middle of the night, and so on.

A wealth of insight, until Orsi makes an error of conflation; psychoactive drugs, are not like antibiotics: they do not cure disease, they merely treat symptoms.

The introduction of penicillin after the war, antibiotics in the late 1940s, and the psychoactive drugs like Miltown and Valium in the 1950s and 1960s, along with the growing sophistication of medical technology in the same period, vastly improved the capacity of medicine to cure and sealed the hegemony of the organic interpretation of sickness. Conversation and history taking were all but replaced… as doctors became thoroughly disease- rather than patient-centered.  Medical education overlooked the broader social and emotional contexts of sickness. The inevitable result was the gradual disempowerment of the patient and the “depersonalization and dehumanization of [health care]” in the words of a prominent physician commenting on the “death to the clinician” in these years.

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