Current psychiatric practice, dominated by bio-psychiatry, follows a one person model. According to this model, the patient has an illness, and the psychiatrist is supposed to fix him. The psychiatrist is expected to diagnose the illness and prescribe medications to treat it. This model of treatment is embraced by many, both psychiatrists and patients.
A two person psychology, as seen for example in psychoanalytic psychotherapy, recognizes the interplay between a patient and their therapist and the influence of the observer on the observed. In a broader sense, it recognizes that people are not inflicted with a disease. They suffer from a problem; a human condition. They are stuck in a certain position. It is quite possible to understand the problem, though it can take time. Through this understanding, through the relationship with the therapist, people can get ‘unstuck’, and live a happier life. People can change; one way to bring about change is by a shift in perspective.
What’s this you’re writing?” asked Pooh, climbing into the writing table. “The Tao of Pooh,” I replied. “The how of Pooh?” asked Pooh, smudging one of the words I had just written. “The Tao of Pooh,” I replied, poking his paw away with my pencil. “It seems more like the ow! of Pooh,” said Pooh, rubbing his paw. “Well, it’s not,” I replied huffily. “What’s it about?” asked Pooh, leaning forward and smearing another word. “It’s about how to stay happy and calm under all circumstances!” I yelled. “Have you read it?” asked Pooh. -The Tao of Pooh, by Benjamin Hoff.
Too often, when people are told they have this or that diagnosis, they cling to this diagnosis as an all encompassing explanation for everything that is wrong with their lives. More than an explanation, it becomes a way of life. It becomes a self imposed prison. When people cling to one vision of themselves and can’t let go, they also can’t move on.
In Buddhist philosophy, there is no permanent self. The idea that there is a fixed self is a delusion. And if there’s no fixed self, there’s certainly no fixed ill self. Shedding the attachment to a diagnosis can be immensely freeing. You’re giving yourself permission to get on with it.
It’s like that moment when you first learn to ride a bike. You forget yourself, that self which couldn’t possibly balance on two thin wheels. You forget to fall, you just let it happen – and there you are, riding a bike, the wind blowing through your hair, laughing with joy.
Psychiatry focuses far too much on the supposed fixedness of illness, the supposed objective reality of diagnoses, and far too little on letting go. There should be more bike riding in psychiatry, more surfing, more embarking on interesting journeys.
To paraphrase the aliens in ‘The Fifth Element’: Diagnosis not important. Only life important.
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Great Insight..
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