Psychiatry

S.Q. Lapius had just explained the four psychiatric models currently in use, the Medical, Psychological, Behavioral, and Social, none of which dissolved the clots of confusion that obstructed my mind.  The medicinals that James the bartender dispensed, although not diminishing the confusion, somehow made it seem less important.

“There, Harry, you feel better,” Lapius noted.

“Alcohol is no solution,” I replied.

“But it’s relaxing,” soothed Lapius, already quite relaxed himself.

“I guess we’re the alcohol generation.”

“Spiritus fermenti, Harry, is a time honored remedy.”

“Fifty years from now some one will be saying that about marijuana and heroin, I guess,” I said morosely.

“Perhaps.  Particularly if we learn to govern their use.”

“Certainly the prevalence of these drugs, alcohol included, is testimony to the failure of psychiatry to spread its benefits quickly and economically to the majority of the public.  Man’s mind is like an iceberg, about 10 per cent of which is rational, the other 90 per cent buried deep in the unconscious.  There is no unwritten law that says the mind of man has to be rational, that it is born rational.”

“How do you define rational?”

“I think of it in terms of the system in which a person lives.  In western civilization it means some logical process of thought, that came down to us from the Greeks, got lost somehow in the dark ages, and was resurrected by the arduous ‘thinking’ labors of Bacon, Descartes, Copernicus, Newton, Einstein.  Our entire technology has been built on the logical sequences that we have extracted laboriously from nature.  Science has an appealing advantage in that truths can be proved, and problems can be solved.  But there are civilizations in which it is rational to be entirely religious, and in these societies there is very little technology.  In fact there is poverty, but it is accepted as part of the nature of things.  We in our society would consider that irrational, and they would of course return the compliment.”

“What has this to do with psychiatry, which is what I thought was the subject.”

“Simple, Harry, the ‘irrationalities’ of those religious societies are being introduced into our society.  Of course you must remember that all religion is fundamentally not rational, as it is a function of faith.  Traditional religions are acceptable irrationalities, in that they function for the society in which they are predominant.  In the western world the Judeo-Christian religion until recently has satisfied man’s yearning for knowledge of the metaphysical, so that the rest of his mind has been free to investigate, build, create on a logical basis.  Ergo, our technology has developed.  Some more easterly religions, however, are so encompassing, that there is no mental energy left over for creative thought.  Ergo, no technology.”

“It sounds simple, Simon.”

“Harry, please don’t juxtapose my name with ‘simple’.  Anyway, what I was trying to say is that psychiatry is an attempt to quantify the great unconscious.  Successful religions simply harness it; they don’t try to define it.  But here in the west, we try to adjust it to our traditions of logic and measurement.  The new breed will dispense with terms like schizophrenia.  They will say that a New York schizophrenic transplanted to India will not be a schizophrenic.  That everyone has several different personalities.  The concept seems to have originated in the literature of Herman Hesse, a book called Steppenwolfe, sort of a bible to the youth.  He felt that the people had a right to express their different personalities without being incarcerated in asylums.  Then comes J.D. Laing, who claims that schizophrenia is merely a sane response to an insane world.”

“Yeah I’ve heard that stuff.  The earth is the insane asylum of the universe.”

“Ha ha ha, that’s a good one,” Jimmy the bartender said.

“Please, James,” Lapius admonished.  “This is a serious conversation.”  Then he turned to me.  “Precisely, Harry.  Anyway, what has happened is that the ungovernable unconscious in western civilization is no longer bound irrevocably to the Judeo-Christian tenets and is floating free.  There is mass floating anxiety, the depression of the drug-users, and the unacceptable irrational pseudo-religions that have sprung up.  Psychiatry used to have a base-line from which to work.  But now it is splintered in direct proportion to the splintering of the religious base of the nation.”

“Do you believe the nation has lost its spiritual base?”

“No, not lost.  Splintered.  Instead of one belief there are many.  Hindu mysticism is becoming popular.  Thousands of people are reciting mantras before bhagwans, swamis and self-proclaimed maharishes and gurus.  There are witchcraft clubs in California.  Thousands seek peace and unity in the lotus position and others proclaim salvation while standing on their heads.  The entire society has lost its sense of unity.”

“Are you saying that our society in America is schizophrenic?”

“No.”  Lapius said bluntly, “I am not saying that.”

“Excuse me.  It sounded like it.  After all, if our society has lost its unity, it has become many different selves.”

“Correct, Harry, but here is where I differ with the latter-day soothsayers, with their denial of the existence of schizophrenia.  Certainly an individual can have many different selves, but if he is normal, he is aware of the different faces he exposes to different conditions, and deep down, recognizes them as extensions of a unitary self.  The same with our nation.  To date we can indulge the splintering because the nation still has a sense of itself as a unitary society.  Only when that deep intrinsic sense of unity is destroyed will the nation become schizophrenic.”

“Then what.”

“It will falter.  It will lose its cohesiveness.  It will lose its identity.”

“And psychiatry?”

“Psychiatry can’t function in a void.  It has to have a value system to relate to.”

“Then psychiatry itself is becoming schizophrenic.”

Lapius drew a deep breath, then said, “I’m afraid so, Harry, I’m afraid so.”

“No hope, then.” I muttered pessimistically.

“I didn’t say that.  Of course there’s hope.  Civilizations manage to become unified through some value system or other.  A God they can all believe in.”

The drunk next to us smashed his glass to the floor and shouted jubilantly, “Out with the old God, in with the New.”

Lapius watched in astonishment.  “But we may be in for a very difficult transition, Harry.”