Altered states
Marino, Gordon
Gordon Marino ALTERED STATES Pills alone won't cure the blues of long ago I bumped into one of my student advisees. I hadn't seen him for a couple of months and I asked him how he was faring. A...
...The old orthodoxy was that medication was taken to facilitate talk therapy, not to replace it...
...But the young woman assured me, "It's nothing but a chemical imbalance...
...Now, however, you can transform yourself in the comfort and privacy of your own home...
...In other words, bring on the lethean elixirs...
...Coles literally moaned, "It is a tragedy...
...A few weeks after the president's council published its concerns about "the medicalization of self-understanding," Robin Hening wrote a New York Times Magazine piece on drugs being developed that aim at obliterating traumatic memories...
...In practice, though, 80 percent of the psychotropic drugs prescribed today are doled out by general practitioners...
...In psychological healing today, patients are attached no longer to their therapists but to their medication...
...In a preface to the second edition of his The Mind's Fate: A Psychiatrist Looks at His Profession (published in 1995), Robert Coles observed, "These days, more and more, psychiatrists think of their patients as neurochemically unbalanced in one way or another, as challenges, therefore, to a gradual process of drug initiation and titration...
...Last year, a student approached me at the end of the semester to ask for an extension on her final paper...
...And some people in the mental-health business continue to acknowledge this piety...
...Once again, the common view is that the best way to deal with disruptive experience is to alter our underlying chemistry...
...A growing number of patients spend little or no time talking with their doctors about their everyday difficulties in getting through life...
...The way he said it you would have thought that they had found a virus or bacterium in his brain...
...Whatever else can be said about the various forms of talk therapy, they all abided by the Socratic dictum "Know thyself...
...Psychiatry has become a vehicle for the repression of the Socratic imperative...
...tin in~icvui ^ N r ti5c, SCHWADRON Commonweal 9 May 21, 2004 Informal Fallacy Brought to sentences by his sister's birth, the boy who had decided to be laconic decided if he wanted food he better talk—and fast—or she would own the kitchen...
...Coles observed, "I wonder at this point why I am so concerned...
...A warm and congenial young man, he smiled broadly but then his shoulders slumped as he confessed, "I have just been diagnosed with ADD...
...Then, interrogatives: Father dear, what is your favorite candy...
...A boy adept already at the tyranny of either/or...
...For all the old rhetoric about wars on drugs there seems to be no limit to our appetite for pharmaceutical solutions to problems in living...
...I fell in love one day, only it was not with a person...
...The young man responded by jumping up and down so that I could hear the chimes of pills rattling in his backpack...
...In psychiatric circles it was, until recently, traditionally believed that psychic healing took place through a relation-ship with the therapist...
...In-deed, in an ethics course I taught a couple of years ago at another college, I stumbled onto the topic of medication in our final session and found that two-thirds of the students had been or were on regimens of psychotropic drugs...
...I suspect that only a small percentage of patients who get their meds from family doctors are also in talk therapy, which is to say, that the notion of taking medication in order to facilitate a therapeutic relationship and emotional reflection is largely passe...
...Yet, I think, it would be hard to argue against the notion that the individual who works to understand why he hates himself will end up with a different character from the person who quiets his carking inner voices with chemical cocktails...
...however, short of becoming unhinged, there is good reason to believe both that our emotions have something to tell us and that the way we respond to our emotions is a significant part of the curriculum of our lives...
...Ac-cording to the latest figures, an astounding one in eight Americans is now taking antidepressants...
...In other words, for Coles, the crummy feeling the young man was trying to short circuit was the intellect at work trying to understand loss and the anxiety of decision making...
...He was not worried that I would think he was daft, because he knew that these days virtually all are going into the medicine cabinet to find themselves...
...The doctor's brother was dying and he was on the brink of some major life decisions...
...According to Niebuhr, just as a nation must come to understand its history so must the individual reckon with his or her past...
...The medicalization of emotional malaise invites us to imagine that chemistry can do the same work as reflection, just more quickly and efficaciously...
...In her candid Prozac Diary, Lauren Slater coos, "Falling in love is a state of surrender, not necessarily pleasant...
...A novice psychiatrist on antidepressants told Coles, "I feel good now where I used to feel crummy all the time...
...Like a de-pressed person, you let yourself go...you just say yes...
...This attachment may speak to the puzzling fact that the placebo effect of Prozac is a whopping 39 percent...
...and how do you spell souffle...
...Commonweal I 0 May 21, 2004...
...Captains of the mental-health industry believe that depression is still underdiagnosed and that with just a little more public education, every fifth adult American will soon be groping for peace of mind in a prescription...
...rather they hope for a kind of calm to settle on them courtesy of a pill that will do its work, cast its magic spell by dint of its effects on the brain's circuitry...
...Freud argued that our belief in God was simply the expression of a wish...
...But this benefit, if it is that, may well come at a considerable cost...
...Of course, when such feelings completely unhinge us, medication is appropriate...
...A few minutes later she told me that her parents had recently announced they were getting divorced, but she quickly added that she was certain their break-up had nothing to do with her blues...
...And then of course, how could he not, imperatives: Laugh, sister, or I'll cry out loud and Feed me, Cookie jar, or I'll break your empty heart in two and Allow me passage, Stairs, or I'll fall down and break my crown...
...Martin Galvin self-examination and self-recrimination as well as arduous attempts to change the way he lives...
...It is the kind of thing that [Erik] Erickson used to say that we can only pray about and rebel against...
...The ease with which we now resort to chemical solutions for psychological problems is nothing short of alarming...
...Coles offered this assessment almost ten years ago and the winds have by no means shifted—they are only gusting stronger...
...Coles fumed, "We are linguistic creatures and anything that cures us has to involve language and making connections...
...Perhaps I have the old-fashioned sense that this young man in fact had good rea-son to feel some anxiety, some moments of sadness...
...More to the point, you can do it without ever making yourself vulnerable to another human being or threatening your sense of being in control...
...Maybe so, but the same could be said about the current faith in pharmaceutical engineering...
...Olaf College in Northfield, Minnesota...
...I boy, I eat and I love you, Mother Mine, Daddy-O, every-body...
...Coles noted that many young physicians were healing themselves with the same balms they prescribed for patients...
...First, he tried the old declaratives...
...I asked, "Did some-thing happen...
...Most people would prefer to avoid sorting through the basements of their past, much less doing it with a stranger...
...According to current dogma, anxiety and depression are simply symptoms that impede our ability to function...
...For one receives sadness as sickness only by emptying it of psychic or spiritual significance...
...Although he approached this problem from Christian pre-suppositions, theologian H. Richard Niebuhr did not think that one needed faith to grasp that "in the life of the self, responding to action upon it in the present...does not come through the rejection of the past but through its reinterpretation...
...And yet modern psychiatry increasingly proceeds as if we could become ourselves without any serious study of the pages of our own past...
...Should I, Sweet Mother, eat the skin of the green cantaloupe...
...In Beyond Therapy: Biotechnology and the Pursuit of Happiness, a recent report from the President's Council on Bioethics (see Andrew Lustig, "Immortality, " Commonweal, February 13), the authors observe, "a person who attributes his discontent or sadness to sickness may spare himself difficult "1I niry Nrurt'1 iii ii I1it)7Irl/, I1 ttI Irnu...
...What's the treatment plan...
...He can take mood brighteners without guilt or without any sense that he is missing something...
...Kierkegaard once remarked that there is "nothing worse than thinking of your own emotions as twaddle," that is, as psychic perturbations devoid of meaning...
...And yet that is the attitude toward our emotions that many in the medical/priest class adopt today...
...I recently chatted with Robert Coles about the overwhelming American passion for pills...
...When asked what he thought was making him feel crummy, the young doctor drew a blank...
...Some of the psychic pangs that we are encouraged to cast pills at today are the invitation to that seminar with ourselves...
...Gordon Marino is Boldt Distinguished Professor in the Humanities and curator of the Hong Kierkegaard Library at St...
...Of course, there aremany who will wince at the puritanical connection between pain and human flourishing...
...Who isn't ADD...
...I jokingly consoled him...
...According to the old syllabus for our sentimental education, psychic pain is part of the material that must be mastered for human growth to take place...
...In reply to the concerns expressed by the council, Hening wrote, "If we as a society decide it is better to keep people locked in their anguish because of some idealized view of what it means to be human, we might be revealing ourselves to be a society with a twisted notion of what it means to be human...
...Such dictums read quaint and hyperbolic today...
...She told me that she was "clinically depressed...
...or what...
...it was with my pill...
...Bring on the soma...
...A tragedy," he said...
Vol. 131 • May 2004 • No. 10
