We Need a New Psychiatry

   Louis Menand’s article “Head Case,” in the March 1, 2010 of The New Yorker asks,  “Can Psychiatry Be a Science?”

     There is no simple answer to that question.  Freud’s whole life was devoted to making psychotherapy into a science.  The immediate fragmentation of his work into multiple schools gave an indication of how fraught with ambiguities such an effort is. To make psychiatric treatment a “science” requires definitions of diseases, their origins, etiology, diagnosis and treatment that are as materially based as those applied to the treatment of physical diseases.  Instead, psychiatric efforts are dogged by ambiguity, litanies of expanding “syndromes,” some of which supposedly relate to the same “disease.” The derivations of these syndromes, as collected in the “manual” of psychiatric diagnoses, called the “Diagnostic and Statistical Manual of Mental Disorders (DSM), turns out to be more indicative of social norms than “material” conditions of disease. 

     This is no surprise.  Anyone who is familiar with the termination of persecution of witchcraft or of the wider acceptance, in some circles, of the deviant behaviors of artists, for instance, knows how social norms shape our perception of what constitutes a mental “disease” or “disorder.”  Of course, the increased diagnosis of ADD, for instance, indicates a (compensatory? – we always need our demons) shift toward increasing ascription of deviance and less toleration of disruption to the machinic processes we think of as being normal.  For the philosophers, Foucault’s Madness and Civilization speaks exactly to this issue (while his The Birth of the Clinic speaks to the social basis for the identification and treatment of what we now call disease – creating two moving targets in this discussion). 

      I see the whole discussion as stemming from a huge category mistake.  Grant that the medical diagnosis of physical diseases has merit and is effective – a proposition that also seems to be contested by holistic and homeopathic orientations.  Medical treatment of physical tissues is made possible because physical tissues are relatively stabilized into somewhat machinic, repetitious sequences and relations (still vast, not fully demarcated or understood) for which triggers and modulators, if not effective blockers, can be found. 

       Treatment by pharmaceuticals or surgery or rehabilitation is effective within prescribed ranges.  By contrast, psychic processes are completely relational and self-generating, differentiating and auto-stabilizing from moment-to-moment.  Even so-called “normal” behaviors are set in motion by complex, variable and only partially stable (within a range of internal and external limits and thresholds).  Thus, there is no firm basis on which a “disease” can be labeled (other than neuronal dysfunction or atrophy or over –production) in a way that is analogous to physical disease.  This is a largely mistaken route engendered by an over confidence in the materiality of the “mind-brain” connection. 

     This overconfidence is precisely the “affliction” that quantum mechanics and relativity and their offspring overcame in the realm of physics.  Freud’s model suffers from exactly the classical presuppositions of materiality, action/reaction and absolute space that marked the (Newtonian) physics of his time.  

The model of self-organization, the model of psychic/somatic self-generation and ordering holds great promise for re-orienting our comprehension of the mind, just as quantum physics offered whole new vistas of comprehension and engagement with the physical world. In this model (see Theren and Smith, Stuart Kauffman, Varela or Kelso, for example) there are no fixed mental parameters, only the massively collective self-organizing dynamics of self-forming engagements.  

     If Freud had the self-organizing model to appeal to, for instance, he could have cited the drive of the psyche to generate new awareness out of free flowing energies (in language and in abundant physical connection) as being constrained into certain channels, instead of having to defend “material” forces (Newtonian point-to-point constellations of motion) such as libido, sex drive and even the death instinct. 

        Instead of contemporary “anxiety” or even “depression” we might be able to embrace highly differentiated modes of engagement of an organism grappling with radical self-organization on more or less moment-by-moment bases, as opposed to “fixing” a body of machinic processes that is “supposed to” behave in prescribed ways.  From there, we could engage in ameliorative actions that all parties work through so as to foster the greatest expression of those energies, without stigma, without drugs, but with genuine prospects for “health” of that being, We could engage with each other as beings living their ways into ambiguity and community. 

       This would be a new psychiatry, a generative one for all involved, to be sure. 

       We have far to go.

Crazy Times in Exo-Memory

    In the spirit of Louis Black, here is a news story that for sure fell between the cracks: according to an article in the New York Times, Feb 28, 2010, “Week in Review” (p. 3),  a fiction writer has copied huge passages from another author into her novel and still calls her work “original.” Another fiction writer cited in the article is unapologetic about wholesale appropriations, while another is “creating” a whole book that consists only of such quotations. This is really taking Tom Lehrer’s idea “plagiarize, plagiarize, plagiarize and always call it research” to another level.

    My reaction: a qualified, “go for it.”  This may actually be a positive turn in the creative endeavor.  Here is why I think that:

    Maybe the human “exo-memory” is now becoming more and more being freed from ownership, and is now more open for engendering more expansive human creativity. 

    Exo-memory includes all our cultural productions and artifacts, but it entails much more than that.  It comprises the actual contents of the memories of individuals, peoples and humanity itself – memories that used to be locked up in individual minds, conveyed only through creation narratives or in the secret rites of peoples. Humans have evolved in concord with their abilities to place objects that encompassed “meanings” for the people out into the external world.  These objects started as tools and artifacts, then became words and narratives, then icons, and then moved into writing – commandments, narratives, poems, dramas and histories, and then philosophies.

    As Leonard Shlain points out (The Alphabet versus the Goddess), great shifts in the sense of what it is to be human, and how to order human life correspond to developments in being able to disseminate this vast and expanding and enriching trove of externalized memory to wider groups of people. Merlin Donald, the evolutionary cognitive scientist, also marks the onset of the truly human “mind” as occurring when humans were able to place symbols and artifacts out into the public as means of defining a people (Origins of the Modern Mind). After at least 5 millennia of concerted effort, with the advent of the Internet, our collective exo-memory is “out there,” ready to be plumbed, dispersed, proliferated and launched into creative futures.

      What is new in these authors’ claims is that purely human “artistic” activity -- tied neither to material observations of nature nor to divine pronouncements -- is now seen as providing constituents of genuinely creative engagements. Human creativity is now placed right there, at our fingertips, in just human form, as just a fiction or a “fact,” or an image, forming a new, tentative, provisional and risky platform for the next engendering. 

      Using purely human productions as a basis for presenting “creative art” is not without precedent:  Warhol and Duchamp were already casting every day objects into modes of presentation (on canvases and pedestals) and contexts of display (galleries and museums) that was once reserved for works aspiring to “high art.” These icons of “pop” art were presented as paradoxical, ironical and interrogatory; they posed a challenge to weary, exhausted, secularized experience.  Maybe, by claiming these authors’ compilations of existing writings described as original works, help us ask different questions: are we adequately sensitive and awake to the creative powers the human endeavor encompasses; and are we ready to embrace the vanishing, ephemeral, useless quality of these powers as all we have?

     Let’s face it, as the music industry and the publishing world are experiencing first hand, the proliferation of creative works, spilling out beyond the reach of the gatekeepers has changed our relationship to human creative efforts. And the dangers of the liberated proliferation of human expression are also apparent. The web echoes and amplifies suspicion or ignorance-based rants; these pathologies become entombed in halls of mirror websites and cable channels where they become rarified and rendered more amenable to death-dealing extremism (as holy writ, as is the case in much of the internet-spawned nut cases that collect in religions cults and tea party- like political movements).  Sadly, as Shlain points out, this kind of infantilism with new media goes hand in hand with the proliferation and freeing of exo-memory into ever-wider populations.

      But…, maybe., despite these inevitable slippages and dangers, maybe this new mode of “originality” in literature marks a different kind of “listening” to each other than has occurred before. Previously we trusted the words of each other only if there was some “divine” element to it, or if the words had been “blessed” by being in accord with a set of prescribed principles or marks of “genius.”

      Publishers squirm, or feel a death rattle coming on. What this plagiaristic, derivative creativity means for copyrights is anyone’s guess.  But then the private appropriation  (or the institutional variant of this) of art has always been a (necessary evil) barrier to a more expansive and more encompassing sense of the human

And so…, maybe…, despite these dangers, maybe… these developments harbor the potential to mark another great shift in the enrichment and deployment of human exo-memory, in its comprehension and use – on a par with the fusion of writing and the printing press: maybe we now are appreciating how the human endeavor provides the landscape and material, the energy and the trajectory for shaping our destiny as a species. 

     Perhaps it marks the realization that we humans live at our best, when we bootstrap.  We are at our best, not when repeat received wisdom or codified, given “natures” but when we hearken to our own creativity and listen for the freshness and vitality that is brought forth thereby.  And then, take what we have heard in order to generate the next endeavor. We get to take our conversations as invitations to our aspirations and creativity, right there, right where we are, right with our most challenging of acquaintances and our most generative of friendships.

     …maybe…