Sunday, May 26, 2013

Why we URGENTLY need secular-humanistic psychology

I was reminded during the past couple of weeks of the pressing need for a humanistic vision of psychiatry/psychology due to two developments: an upcoming conference about pediatric medicine hosted by…the Vatican, and an article by an author, James Davies, whose book I just recently mentioned here.

A post last month at Mad in America drew my attention to an upcoming meeting at the Vatican about “the child as patient,” organized by the World Federation of Catholic Medical Associations, in which several authors critical of biopsychiatry will participate. I don’t know that I have words to describe my horror at reading about a conference on children and medicine hosted by the Vatican. As perverse as “the Vatican and children” and “the Vatican and medicine” are separately, the combination is grotesque. Honestly, I had no idea their pediatric psychological web was so developed.

The problem isn’t so much these experts participating in the event (although that’s by no means thrilling), though, as what the meeting signifies. With regard to James Davies, prior to posting about his book, I’d noted, but not investigated, a few potentially troubling aspects: that he’d spoken at the Harvard Divinity School, that this book was favorably reviewed by Peter Hitchens, that he’d written a book entitled The Importance of Suffering. So I’ve now had time to look into it, and discovered that, indeed, religious nonsense pervades his thinking.

In this piece, Davies contrasts “positive” and “negative” visions of suffering – “the different presuppositions about emotional suffering underpinning the psychiatric and Christian responses to emotional distress” (this is especially interesting to me in that I recently discussed this question in relation to assisted dying):
I was led to reflect that the psychiatric management of despair is premised upon a very different vision of suffering from that which Christianity traditionally professes. In short, psychiatry appeared largely to advance what I would call a "negative model of suffering," while Christianity, in its more traditional forms, seemed to advance a "positive model of suffering."2

The positive model holds that suffering can have a redemptive role to play in human life, that from affliction there can be derived some unexpected gain, new perspective, or beneficial alteration. If this vision of suffering could have its motto, Thomas Hardy captured it well in his poem In Tenebris II: ". . . if way to the Better there be, it exacts a full look at the Worst." The positive vision, thus considered, sees suffering as a kind of liminal region through which we can pass from a worse to a better place. Or alternatively, suffering is a natural outcome of confronting certain unpleasant facts about the human and natural world, facts we may well need to confront if we are to live more firmly rooted in reality.

The negative model asserts quite the opposite view—namely, that little of value can come of suffering at all. It holds that there is no new vista or perspective to be gleaned at suffering's end, nor any insights to be retrieved from its depths. Suffering is thus something to be either swiftly anesthetized or, better still, wholly eliminated, for what good is an experience whose most obvious features are pain and inconvenience?

The positive vision of suffering is at the heart of traditional Christianity. This can be illustrated by the Christian idea of spirit, which is traditionally understood in two generally accepted metaphysical senses: first, as describing an element of God which reaches down to the individual through expressions such as the Holy Spirit; and second, as an element of the individual which reaches up to God for the soul's total purification. In either correspondence (from God to individual or from individual to God), suffering has been regularly acknowledged to play its part, as if very few "summers of divine communion" can be won without a preliminary season of struggle and sorrow. Martin Luther captured this idea well:
God works by contraries . . . a man feels himself to be lost in the very moment when he is on the point of being saved. When God is about to justify a man, he damns him. . . . God's favor is so communicated in the form of wrath that it seems farthest when it is at hand. Man must first cry out that there is no health in him. He must be consumed with horror. This is the pain of purgatory. . . . In this disturbance salvation begins.3
Luther understands purgatory not as a geographical domain lodged between the earthly and heavenly realms, but as a stage or period of human life during which we become conscious of the flawed portions of our humanity—a stage which is inherently painful, because to overcome our defects we must first see them, and seeing them hurts….
Davies calls the negative biopsychiatric vision the heir of the Enlightenment, in contrast to the positive vision characteristic of Christianity. The negative vision maintains that “emotional suffering does not facilitate, but rather impedes human advancement” and needs to be managed and anaesthetized, while the religious vision holds that that “suffering is implicated in our moral or spiritual advancement” – some portion of it “purposeful, ennobling, holy, or transformative.” (Amusingly enough, Davies finds that in practice biopsychiatry and religion are wholly compatible, both being authoritarian and all.*)

There’s a kernel of truth to the first part: biopsychiatry is the inheritor of certain problematic aspects of “scientific” thinking. The “positive” Christian vision is, frankly, blather, and dangerous blather at that. (The part about being rooted in reality is breathtakingly funny.) And the suggestion that these are the only options is absurd. In reality, both the religious and the biopsychiatric visions of human suffering are false, harmful ideologies.

Psychiatry is collapsing, probably (hopefully) sooner rather than later. This is inevitable: it’s pseudoscience. The danger is that religion and other forms of woo see an opening to exploit. If biopsychiatry is the only alternative to a “spiritual” vision of human problems, and it fails, the field is open for religion. And this “positive” vision of suffering is an equally useful ideological accompaniment to neoliberalism and empire. The happiness, the lives, of millions of people are at stake. We have a choice. We need, at this moment more than ever, a clear secular-humanist vision of psychology that avoids the traps of both religion/woo and psychiatric pseudoscience.

We can pursue a humanistic path, which understands human psychological suffering in existential and political terms; which doesn’t superstitiously celebrate, demonize, or pathologize it; which seeks to develop social policies, movements, and arrangements that foster joy and relieve suffering. Or we can turn to the authoritarian superstitions of biopsychiatry or religion.

* “Another factor challenging the idea that ‘psychiatry always advances secularization’ is that many of the websites I encountered did not see antidepressants as threatening Christianity (as I originally did), but rather as working in league with it, irrespective of how the psychiatric vision of suffering might be contrary to the Christian vision.9 These websites provide theological justifications, if ad hoc, for antidepressants being a manifestation of God's love. Many Christian groups, it seems, are adapting to rather than attacking pharmacological remedies by rearticulating their understanding of medicine in terms that enable adherents to reconcile drug consumption with the religious way of life. Pills may mitigate suffering so prayer can be indulged; doctors can be consulted because medicine is part of God's plan; drugs can enable the severely depressed to quit one's bed and return to the pew. Many churches, therefore, seem to be transfiguring these pills into tools that keep church attendance alive, and do not see them as agents of secularization.”

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