By Christopher Harding
July 20, 2016
Source: BBC
Excerpt Source: Psychiatry, the Science of Lies by Thomas Szasz
Photo Source: Unsplash, JJ Ying
Freud saw himself as the “discoverer of a new science.” Others see him as the leader of a cult. Although he claimed that psychoanalysis was a treatment he was not particularly interested in helping patients. Instead, he was interested in penetrating the “secrets” of artists and in exposing “fakes.” When his friend and colleague Theodore Reik (1888-1969) compared him with Holmes, Freud said he would prefer to be compares with Giovanni Morelli, a nineteenth - century art scholar famous for his skill in “detecting fakes.”
Freud was too eager to see himself as a crime buster: “I must draw an analogy between the criminal and the hysteric,” he writes in 1906. “In both we are concerned with a secret, with a secret, with something hidden.” This analogy is part of the larger theme of Freud’s metaphors, masterfully explored in The Tangled Bank by Stanley Edgar Hyman (1919-1970), a metaphoric style-overlooked the most obvious and most important Freudian metaphor of ill, namely, psychopathology: “In recognizing the hysterics to be genuinely ill rather than malingering,” Hyman writes, “Charcot was the liberator,” Hyman fails to free himself of the incubus if malingering that has haunted psychiatry-and psychoanalysis perhaps even-more from its inception.
Hyman emphasizes Freud’s fondness for comparing the method of psychoanalysis with the methods of detecting crimes and art forgeries. “We can see,” he remarks, “Conan Doyle’s hand in the titles Freud gives the dreams, so like Holmes cases” ‘The Dream of Irma’s Injection,’ ‘The Dream of the Botanical Monograph.’” In “The Moses of Michaleangelo,” Freud puts it thus: “It seems to me [Morelli’s] method of inquiry is closely related to the technique of psychoanalysis. It, too, is accustomed to divine secret and concealed things from unconsidered or unnoticed details, from the rubbish heap, as it were, of our observations.”
Freud acknowledges that his interest in other people’s lives resembles the forensic pathologist’s interest in the corpses of persons who lie under suspicious circumstances. Artists who knew him were not pleased. Stefan Zweig, the author of an admiring minibiography of Freud, writes, “If Nietzsche philosophizes with a hammer, Freud philosophizes with a scalpel.” Thomas Mann was more emphatic: “As an artist, I have to confess, however, that I am not at all satisfied with Freudian ideas; rather, I feel disquieted and reduced by them. The artist is being x-rayed by Freud’s idea to the point where it violates the secret of his creative art.”
As I noted earlier, comparing the analyst’s efforts with the work of a detective is moral suicide for the analyst. Who benefits from the detective’s labors? Not the criminal hiding the secret. The detective’s job is to harm not help, the criminal; in the process, he also helps himself and the society he protects from criminals. We see here how readily Freud assumes the traditional role of the psychiatrist as the protector of the community from the “dangerous madman.”
Here, then, is the fly-nay, the elephant-in the ointment. Morelli’s and Holme’s professional identifies and duties are unambiguous: they are experts who detect and expose fakes/fakers and crimes/criminals; the exposed are devalued/punished/ Per analogiam, what is Freud’s professional identity and obligation? Is he a detector of secret/malingerers/miscreants? If so, then his duty is to expose and punish them as fakers. Or is Freud a mental healer, a doctor of medicine whose duty is to help-never to harm-his patients? But if, as I maintain, his patients were not”ill” because there are no mental illnesses, then were are no treatments for them, psychoanalysis is not a (literal) treatment, and Freud did not (literally) treat patients.
What was Freud-the self defined expert on faking-exposing? He maintained that he was exposing the erroneous explanation of hysteria as counterfeit illness. This exposure was necessary, he said, to make possible its replacement with the correct explanation of hysteria as a real illness, psychopathology.
Freud was playing a taxonomic shell game. In the conventional medical view, if the illness is fake, so too is the patient, the diagnosis, and the treatment. In Freud’s interpretation, the “fakeness” in hysteria lies in attributing it to bodily (somatic) pathology instead of mental (pyscho) pathology. His explanation leaves us with the following parallel: Morelli identifies forged artworks, Holmes solves baffling crimes, and Freud discovered the hidden psychological causes/determinants of psychological causes of so-called mental (psychogenic) illness. Crimes are facts. Psychological causes and psychogenic disease are fictions.
In the pre-Freudian scenario, malingering is self-created. In the post-Freudian scenario, it is still self-created but with this twist: it is caused by the “unconscious self” without the knowledge of the “conscious self.” At one fell swoop, Freud “discoveries” the causes of the illness and “cures” it. Both the discovery and the cure are fraud: there is no illness, hence, there is no cure.
KYUSHU, Japan
Depression was not widely recognised in Japan until the late 1990s
When an advertising campaign called it a "cold of the soul" sales of anti-depressants boomed
Now some have been accused of faking depression to get time off work
I'm sitting on a psychiatrist's couch in southern Japan, turning the pages of a manga by the artist Torisugari.
The artist himself sits beside me, talking me through it in hushed tones. We pause over an image of the manga's main character starting to plummet downwards as the Earth fragments and gives way beneath his feet
"The world that had supported me up until now is breaking up and falling away! I can't even stand up any more!" says the character, Watashi (whose name means "I" in Japanese).
The image represents the artist himself more than a decade ago. Working impossible hours at his job as a civil servant, often going without sleep, one day he found a single thought circling round and round in his head: "I have to die."
Torisugari had no idea what was happening, and his fear was deepened by the incomprehension of those around him. He kept a suicide attempt secret from his parents, instead going to a doctor to have his heart checked out - there was nothing wrong with it.
At the age of 29, Torisugari was embarrassed to find himself begging his mother not to leave the house without him. His father insisted this was all just attention-seeking. His best friend said the same and told him to get some exercise
Everything in his life seemed to be disintegrating - the world was becoming a strange place, and his relationships were failing him.
Finally, another doctor gave Torisugari a diagnosis: depression. He had never heard of it. There was nothing unusual about this. Up until the late 1990s in Japan, "depression" was a word rarely heard outside psychiatric circles. Some claimed this was because people in Japan simply did not suffer depression. They found ways to accommodate these feelings while somehow carrying on with life. And they gave low moods aesthetic expression - in art, in film, in the enjoyment of cherry blossom and their fleeting beauty. A more likely reason is Japan's medical tradition, in which depression has been regarded as primarily physical rather than a combination of physical and psychological, which would be more common in the West. While the diagnosis itself was rarely used, people suffering classic symptoms were likely to be told by their doctors that they simply needed to rest. All this made Japan such a poor prospect as a market for anti-depressants that the makers of Prozac all but gave up on the country. But then at the end of the 20th Century a remarkable marketing campaign commissioned by a Japanese drugs firm helped turn things around.
Word was spread about depression as kokoro no kaze - a cold of the soul. It could happen to anyone, and medication could treat it.
The number of people diagnosed with a mood disorder in Japan duly doubled in just four years, as the market for anti-depressants boomed - in 2006 it was worth six times what it had been just eight years before.
In a country as open as any other to the celebrity confession, everyone from actors to newsreaders now seemed willing to come out and say they had had an experience of depression. This new illness was not just acceptable - it was even slightly fashionable.
Depression also entered the courtroom. The family of Ichiro Oshima took his employer - Dentsu, Japan's largest advertising agency - to court, after Oshima killed himself following months of heavy overtime.
The legal battles that followed garnered huge public attention, as the family's lawyers successfully showed two things: depression could be caused by a person's circumstances, including overwork - it was not purely about genetic inheritance, as Dentsu tried to argue - and Japan's still-prevalent ideas about suicide as straightforwardly intentional, even noble, were inadequate. Japan's leaders were rattled. Mental illness had gone from a hush-hush family matter to the focus of a workers' movement. And what had once been a natural expectation that working women especially would "sell their smiles for free" - helping create the eager willingness and inexhaustible good cheer that Japanese customers have come to expect - was now being talked about as "affective labour": emotional or psychological graft.
A suicide prevention law was passed in 2006, pledging to reduce suicide rates and declaring suicide a social rather than just a private problem.
And since 2015 Japan has brought in workplace stress checks. A completed questionnaire covering causes and symptoms of stress is assessed by doctors and nurses, leading to medical care for those who need it - with results kept confidential from employers. This is mandatory for companies with more than 50 staff, and smaller businesses are also encouraged to do the same.
With plenty of public debate, lots of medical and celebrity support, and progressive employment measures, does Japan now firmly "believe" in depression?
Well, maybe - and maybe not. There's evidence of a pendulum swing in the opposite direction, as a rapid rise in work absences and sick leave due to depression seems to be generating a climate of frustration at the impact on colleagues and now even suspicion about the way some people obtain and use a diagnosis.
Some Japanese suffering with depression find that while the rise in public awareness about the condition has been a comfort to them, allowing them to talk openly, their recovery and return to work is hampered by cynical talk around them about "fake" or "bogus" depression - a sign of self-indulgent times.
The limitations of that "cold of the soul" campaign are becoming clear. It was criticised at the time for making misleading links between the common cold and depression. But beyond that, Japan's experience with depression shows how closely tied some forms of physical and mental illness are to broader cultural attitudes - about work, for example, and levels of responsibility towards others. Raising public awareness ends up being a complicated, delicate task.
No-one knows this better than Torisugari, who still has to contend now with both his illness and with some of the same misunderstandings he faced in those early, surreal weeks. Which is why he's decided to produce the drawings we're looking at here, and why his manga are garnering an ever-larger and more appreciative audience in print and online. For him it's a kind of "manga therapy", as his psychiatrist calls it. For others - whether suffering with depression or not - it offers help in understanding the condition.
How can such practices impact one's health? Why? Do you have a loved one in the military?
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