Buddhism, Psychiatry, and Psychology

[viniketa]

I'm starting this topic as an extension of the thread "Life" in "Help Required" (viewtopic.php?f=80&t=10595), particularly to explore the interaction, compatibility, and possible incompatibility of Bhuddist philosophy with modern Western definition and treatment of "mental illness". In particular, Thrasymachus raises a number of issues in the linked thread that are worth more discussion.

One has to do with what might be seen as incompatible views on "the nature of reality" between Buddhist thought and Western psychology. Another topic is the inequality inherent in the current system of both diagnosing and treating "mental illness". The experience of psychiatric treatment is quite different between persons who have (at least) adequate access to diagnosis and treatment and those who have some, but inadequate, access (those living in poverty in Western civilization).

[Indrajala]

I've never seen western psychiatry cure anyone of their mental illness. Never. And I know a lot of mentally ill people. You might disagree, but I have little respect for the profession as it stands now.

Psychiatry incidentally is a kind of decadent luxury in first world countries. Elsewhere people can't afford to be mentally ill. Suicide rates in poor countries tend to be lower, too, probably because you can't afford the luxury of killing yourself, otherwise your family might starve. If you live in a relatively rich country your family might even get a sum of money for your death. Pharmacies, too, make a killer off all these kids with ADD and ADHD taking legal forms of smack.

[viniketa]

Psychiatry incidentally is a kind of decadent luxury in first world countries.

Probably not so incidental, more "built in" to the culture. But the idea of "mental illness" is there, and has some recommended form of "treatment", in all cultures. The differences are in the behaviors defined as "mental illness", the causes theorized to produce such behaviors, and the treatments. One may call the condition "possession" by an "external" spirit, but the idea that the condition is non-normative and threatening is still there.

Like Youdron, I do not think of myself as an "apologist' of medicine. I recognize its limitations, but also many of its benefits. Even beyond psychiatry, the general state of medicine in the West is in bad shape, in my opinion, and it is largely due to the capitalistic appropriation of "cures" as commodities. There are many illnesses, mental and otherwise, that have no cure. It is the nature of degeneration and death among mortals. Most "treatments" are not designed as cures, but rather as methods to manage symptoms and avert immediate death.

[viniketa]

But, further, there is the point that, in Western medicine, there is a tendency to classify any non-normative behavior as "mental illness" for which there is some, usually pharmacological, treatment. For society so adverse to "drugs" as to declare a "war on drugs", Western society in particular and U.S. specifically are the most "drugged" cultures on earth.

Which brings us back to the idea of a conflict between Buddhism and Western medicine. To what extent does a Buddhist view of self-healing contradict the idea of medical treatment of "mental" disorders? At what point do we draw the line? At a threat of suicide? Is it just that we ourselves do not want to deal with suicidal behavior and therefore are more comfortable relegating it to "professionals"? I honestly don't have an answer to this question.

[David N. Snyder]

Buddhism does not teach against using medicine. Even monks are nuns are allowed to take medicine. Medicine could be for a physical ailment or a mental one.

Moderator note: As per our new item added to the Terms of Service, discussion should only be in general terms. In no case should any of us provide specific remedies for a specific person. Each individual case requires that person to make their own choices with guidance from professionals in the medical field.

[Indrajala]

Which brings us back to the idea of a conflict between Buddhism and Western medicine. To what extent does a Buddhist view of self-healing contradict the idea of medical treatment of "mental" disorders? At what point do we draw the line? At a threat of suicide? Is it just that we ourselves do not want to deal with suicidal behavior and therefore are more comfortable relegating it to "professionals"? I honestly don't have an answer to this question.

I once saved a guy from jumping off a bridge. He had just been in the hospital, and then the police came after I wrestled him off the side of the bridge, whereupon they presumably took him back to the hospital.

In the materialist worldview killing yourself is a permanent cessation of consciousness and hence pain also is thought to end.

As a psychiatrist how do you convince someone in great pain that there is a better alternative than killing yourself?

In the Buddhist worldview killing yourself is senseless and quite foolish, and you'll probably send yourself into the lower realms, so it is easy to see the reasoning there. But from a materialist perspective? The abyss of death is far more appealing than a prolonged life of misery.

[Indrajala]

Psychiatry incidentally is a kind of decadent luxury in first world countries.

Probably not so incidental, more "built in" to the culture. But the idea of "mental illness" is there, and has some recommended form of "treatment", in all cultures. The differences are in the behaviors defined as "mental illness", the causes theorized to produce such behaviors, and the treatments. One may call the condition "possession" by an "external" spirit, but the idea that the condition is non-normative and threatening is still there.

True, but in poor countries people usually don't have the luxury to sit at home and lament how they were abused as a child and hence are unable to work. If you live in a welfare state it is often quite possible to receive a monthly allowance from the state if the doctor says you are mentally unfit for work.

In poor countries if you don't work, you might starve. In such circumstances as that you don't have the luxury to be mentally ill. The truly mentally ill people will be actually impaired from engaging in work and this is evident by their behaviour.

Most mental illnesses in the industrialized world such as depression and low self-esteem are psychosomatic. A lot of people are depressed because they're fat and ugly, which is largely due to their own decadence. I won't deny that they suffer, but paying to see a psychiatrist because of your gluttony just strikes me as utterly bourgeois. They have my sympathy, but most 1st world citizens need to first recognize their decadence first.

Like Youdron, I do not think of myself as an "apologist' of medicine. I recognize its limitations, but also many of its benefits. Even beyond psychiatry, the general state of medicine in the West is in bad shape, in my opinion, and it is largely due to the capitalistic appropriation of "cures" as commodities. There are many illnesses, mental and otherwise, that have no cure. It is the nature of degeneration and death among mortals. Most "treatments" are not designed as cures, but rather as methods to manage symptoms and avert immediate death.

[Sara H]

I tend to agree with the spirit of what Huseng says.
Though maybe not the force of which he says it.

I don't nessicarily agree that madness, schizophrenia, bi-polar, and paranoia, and other consequences of willful action, this life or previous, are strictly western traits.

But In general, yes I would tend to agree with the spirit of what Huseng is saying.

I posted about this, an interesting article here:

http://www.dharmawheel.net/viewtopic.php?f=36&t=10548

And I'll post along with that some of the links to the external articles I was talking about here:

http://www.huffingtonpost.com/martha-rosenberg/phillip-sinaikin-psychiatryland_b_884863.html

http://wellnesswordworks.com/by-anonymous-mental-illness-systems-undermine-personal-responsibility-and-morality/

That first link that I posted is particularly interesting and useful.

The second link follows through with it nicely from a former "patient's" perspective.

[Sara H]

It's interesting that I was talking about this very subject with my Spouse today.

I pointed out that if people who practiced/believed in psychology worshiped Freud, and had statues of him and he had blue skin, it would essentially be a religion, or a "new age" spiritual movement.

She noted and pointed out that I'm not the first person who's said that; that other people have pointed out, that it has all the hallmarks of a religion.

One of my concerns about it, is that it is not entirely different from a new age spiritual movement or religion, and yet borrows the credibility of science, and is essentially, a state-sponsored religion.

As a religion, I have no essential problem with people practicing it if it works for them, and I respect freedom of religion.

But in government, and politics, and the law, and courts, But I personally don't think it should be given or awarded a special status of authority or credibility over any other religion or spiritual movement, under the separation of church and state clause in the U.S. Constitution, and other secular laws of other countries.

I realize that it's not strictly-true, that it's a religion, but it's pretty close.


But that's me, personally.

I don't necessarily speak for other people.

In Gassho,

Sara H

[ghost01]

IMO the label of mentally ill is far worse in most cases than the actual problem. It causes people to lose hope, they tell you it's incurable, only treatable and something you have to struggle with the rest of your life. Just look at how people look at the mentally ill, they are scared of them, scared that they might say something to 'set them off', family and friends flock away in herds. Society is sick, mental illness is a reflection of that.

[Thrasymachus]

Personally it always rubbed me the wrong way how so many in this forum like to act as if the hagiography, supernatural claims, etc. surrounding dharma and Buddhism are inherently real. Often they try to brow beat those who think otherwise by claiming they are being less Buddhist or whatever. I always knew such people cannot run around in their day to day life expressing beliefs like that in any Western milieu, at least not without discursion. However, when the topic of mental health comes up we can how many of the same people think also the diagnostic inventions of the mental health field are inherently real, and those people can and should only see a professional(even when the person in question has seen professionals and decided to avoid them). Can you really believe, for example, that Tibetan lineage heads discover reincarnated tulkus because meditation and dharma is that powerful, but that it is also so weak that those diagnosed by mental health professionals should only see mental health professionals?

This is one of the greatest problems of modernized societies. Ivan Illich pointed out that professionals get their power precisely and only by dis-empowering others. The medical professionals get their relative station by teaching society and their specific victims that health is an object they can consume only by seeking out professionals with a monopoly certified by the university system and canonized under penalty of law. In a book the The EFT Manual it reads on the copyright page: "If you have any questions about whether or not to use EFT, consult your physician or licensed mental health professional. The information in this book is of a general nature only and may not be used to treat or diagnose any particular disease or particular person." Every book on health must have a similar silly disclaimer to insure the monopoly of the too well paid medical professionals. Everyone who actually seeks holistic health advice must live with this hypocrisy, buying books with disclaimers saying they are not meant to be medical advice, when if that was the case, they would not be bought! It is madness. When you believe you can do nothing about health other than being the type of consumer known as a patient, that is when your health is really gone and out of your hands. So contrary to those people on this site and elsewhere who think advocating to run to a professional leads to better health outcomes, it doesn't, it leads instead to learned hopelessness and apathy.

Here is a great, short video by Thomas Szasz a psychiatrist and Professor who was perhaps the most vocal and greatest critic against the myriad of abuses by his profession:

... Psychiatrists have for hundreds of years used diagnostic terms, so called diagnostic terms, to stigmatize and control people. ... When black slaves in the South ran away to Freedom, it wasn't that they wanted to be free; they suffered from a disease called drapetomania, from drapetes, runaway slave, and mania. ... Women, half the population of mankind, if they were foolish enough to rebel against domination by man, well they then had a serious disease called hysteria, which was due to their wandering womb. ... Now none of those behaviors were ever a disease. ... No behavior or misbehavior is a disease or can be a disease. That's not what diseases are. ... If he is sick, there must be some objective science to it, which can be diagnosed by physicians and objective tests. ... When I went to medical school sixty years ago there were only a handful of mental diseases. I think there were no more than six or seven. Now there are more than three hundred. ... Labeling a child as mentally ill is stigmatization, not diagnosis. Giving a child a psychiatric drug is poisoning, not treatment. ...

http://www.youtube.com/watch?v=Qj7GmeSAxXo

Long term follow up research on mental health victims who take anti-psychotics has been done comparing their outcomes to those who are not medicated:

Factors Involved in Outcome and Recovery in Schizophrenia Patients Not on Antipsychotic Medications: A 15-Year Multifollow-Up Study(PDF)

Detailed analyses of those patients with schizophrenia on antipsychotic medications versus those not on medications at the 15-year follow-ups also were conducted. These analyses indicated that in addition to the significant differences in global functioning between these groups, 19 of the 23 schizophrenia patients (83%) with uniformly poor outcome at the 15-year follow-ups were on antipsychotic medications. The data on psychosis in Figure 1 show that at the 10-year follow-ups, 79% of the patients with schizophrenia on antipsychotics had psychotic activity, whereas 23% of those not on any medications had psychotic activity. Sixty-four percent of the schizophrenia patients treated with antipsychotic medications at the 15-year follow-ups had psychotic activity, whereas 28% of those not on any medications had signs of psychotic activity.

This is little surprising as in the short term you may feel better, but that is because instead of increasing serotonin or dopamine to improve mood with natural methods like say exercise or prolonged meditation you are doing it artificially by pharmaceuticals, with numerous side effects. So the longer you are on them, the more pointless every life activity becomes compared to popping the next prescribed pill. The whole medical system from research to patient care is dirty. Yes there is research like Harrow's that decries many of the foundational claims of the mental health profession, however no action will ever be taken on it, because no money can be made that way. As Foucault pointed out, knowledge has a relation to power always, and the knowledge that does not benefit those with wealth and political power, gets buried, no matter how beneficial it is to mankind.

There is lots of info out there that shows how medical professionals, professionally dis-empower people. The mental health field tends to make their diagnosed victims into the new lepers, which is very apt especially for those who knew the relevant history between those two groups.

[Yudron]

I've never seen western psychiatry cure anyone of their mental illness. Never. And I know a lot of mentally ill people. You might disagree, but I have little respect for the profession as it stands now.

Psychiatry incidentally is a kind of decadent luxury in first world countries. Elsewhere people can't afford to be mentally ill. Suicide rates in poor countries tend to be lower, too, probably because you can't afford the luxury of killing yourself, otherwise your family might starve. If you live in a relatively rich country your family might even get a sum of money for your death. Pharmacies, too, make a killer off all these kids with ADD and ADHD taking legal forms of smack.

Smack is slang for heroin, an opioid. Treatments for ADD and ADHD are stimulants. There is absolutely no pharmacological relationship between heroin and ADD treatments. None what-so-ever.

[ghost01]

This is little surprising as in the short term you may feel better, but that is because instead of increasing serotonin or dopamine to improve mood with natural methods like say exercise or prolonged meditation you are doing it artificially by pharmaceuticals, with numerous side effects. So the longer you are on them, the more pointless every life activity becomes compared to popping the next prescribed pill.

This is exactly the truth, medicine mask's the symptoms and thus you have no reason to fight it yourself naturally, and after a while you entirely lose the ability to manage your own moods, and other issues, you become dependent on a medicine that may stop working at any time. This is the case with most depressed people and people with anxiety.

Most people do not follow psychotropic drugs up with therapy, mostly because therapy is very very expensive, nor do most mental health professionals even care, it's about the money. It's the sad truth. So people take the pill and let it do it's thing.

[Yudron]

Suicide rates in poor countries tend to be lower, too, probably because you can't afford the luxury of killing yourself, otherwise your family might starve.

The World Health Organization figures do not support this claim. http://www.who.int/mental_health/prevention/suicide_rates/en/index.html

In many countries mental illness, suicide is stigmatized as personal weakness and therefore families and communities conceal them.

[Thrasymachus]

@ghost01:
In Foucault's History of Madness he does some serious comparative historical research that should interest you and ever other mental health victim. Leprosy used to be a huge problem in Europe. In France there were lots of leper houses and colonies to isolate them from the population in every large population center. Eventually leprosy ceased to become a major problem, while simultaneously madness suddenly became a pan-European pandemic. The mad became housed in the buildings originally meant to isolate the lepers from the rest of society. Naturally the negative sentiment once reserved for the lepers extended out to embrace the mad.

However that was not always or uniformly the case. Many here likely know that Abraham Lincoln(1809 – 1865) suffered from melancholy or depression. He even was suicidal and his friends and family had to be on suicide watch for him several times. How did the public react? Many actually voted for him and sympathized for him because of this, it showed he cared. If you notice in the Western world, every great person in the creative fields tends to be depressed. I feel that this is so, because we live in a society predicated on domination, and to be sensitive enough to be attune and expose it artistically, you have to mal-adapted to the dominant social order. Otherwise you would just advocate: "sex, drugs and rock and roll." However, in non-domination societies, like the Piraha as I pointed out in a previous post, the notion of suicide is so alien to them, it is a joke:

Freakonomics: The Suicide Paradox: Full Transcript
...

I was still a very fervent Christian missionary, and I wanted to tell them how God had changed my life. So, I told them a story about my stepmother and how she had committed suicide because she was so depressed and so lost, for the word depressed I used the word sad. So she was very sad. She was crying. She felt lost. And she shot herself in the head, and she died. And this had a large spiritual impact on me, and I later became a missionary and came to the Piraha because of all of this experience triggered by her suicide. And I told this story as tenderly as I could, and tried to communicate that it had a huge impact on me. And when I was finished everyone burst out laughing.
...

When I asked them why are you laughing, they said: “She killed herself. That’s really funny to us. We don’t kill ourselves. You mean, you people, you white people shoot yourselves in the head? We kill animals, we don’t kill ourselves.” They just found it absolutely inexplicable, and without precedent in their own experience that someone would kill themselves.

For us, however, this is not the case and the mentally ill are almost wholly stigmatized now

This is an image from minute 40:42 of the lecture, "the Pleasure Trap" by Douglas Lisle, a Phd psychologist who works with Douglas McDougall to help people adopt a healthier plant based diet. However, I feel it equally applies to pharmaceutical or other drugs which often create a greater co-dependence and addiction than any food:


Basically if you look at the graph, first you are in the normal pleasure zone, which is your base level of happiness and mood without unnecessary enhancements. Then if you take pleasure enhancers like say street drugs or possibly some prescription anti-depressants you are in the enhanced pleasure zone. So if you stop taking the medications you will soon bottom out and go into the sub-optimal pleasure zone. If you push through that travail however, you will soon be back into the normal pleasure zone. The thing about mood alternating substances, is that when you use them for a prolonged time, this is what they will do to you. It is the same with crutches, you use them long enough, your leg muscle atrophy and you lose motor skills and have to rehab to get back to where you were
.

[Indrajala]

Suicide rates in poor countries tend to be lower, too, probably because you can't afford the luxury of killing yourself, otherwise your family might starve.

The World Health Organization figures do not support this claim. http://www.who.int/mental_health/prevention/suicide_rates/en/index.html

I think they do. Look at how European countries (west and east) compare to poor countries like India and Philippines.

Note I said tend to. It isn't absolute.

[Sara H]

I've never seen western psychiatry cure anyone of their mental illness.

I tend to agree with this as well.

One thing psychiatry could be useful for is as a sortof emergency mental-health triage, or EMS.

If someone is calling on a crisis line, and someone with psychology training can talk them out of killing themselves, I think they've done some good.

But as a long term fix?

No, I don't think so.

This would be like the difference between paramedics and doctors/surgeons.

I think psychology can have a role as an "EMS" of mental health.

To "stop the bleeding" in an emergency is one thing.

For "treating" it, or getting to the root of sufferings cause, I don't think they have much of a chance. And can tend to compound delusion, and procrastinate things and even make things a lot worse in the long term, or at the very least waste a lot of time, and effort, and efficiency, getting very little results. I think they are out of their league, in that sense, and need to step aside and let people in who actually know what they are doing.

People who have seen suffering's cause from their own experience, and know what they are talking about, and allow the person to get some real spiritual help.

In Gassho,

Sara H

[Thrasymachus]

I found this excellent image that is really too great to not share:

The Lettrists/Situationists called taking an advertisement or any other image supporting the status quo and turning it against the social order, détournement.

The criminals in mental health and the rest of the medical establishment don't look into the social and economic causes of health issues. What they do instead is put the blame on the patient's genetic inadequacy and give them medications to allow them to putter along in school and the workplace. When the medications are not enough, then they administer surgery or other austere procedures. This excellent détournement, does the exact opposite, giving most the blame onto the social-economic order that causes or exacerbates most health problems.

[catmoon]

I don't think it's necessary to refer to the entire medical profession as "criminals".

I'm pretty sure you would not like it if someone were to refer to people on the other side of the argument in such derogatory terms.

[Thrasymachus]

Overall the medical profession does mostly net harm in anything outside of emergency care(IE. If I saw off my finger, they are excellent at sewing it back) and their purpose is to adjust people to capitalist growth and progress. You don't see doctors out there at the front line presenting medical protests against pollution from the new factory opening near a residential area, opposing new highways which will cause lung problems from all the increased particulate matter in the air, opposing the increasing work hours most people are undertaking which always takes a bodily and psychic toll, opposing nuclear plants, or doing anything in general to promote health in a preventative matter. Actually there are a few exceptions which I could name, but they are too few. What they do instead is damage control for the God of Growth on the tail end by dis-empowering people from taking steps to prevent health problems before they arise, emphasizing an approach laden with invasive testing, pharmacology and surgery.

Like I said before professionals get their power by dis-empowering others. At the other side of the argument medical professionals have utter contempt for those who did not undergo their same university certification and who do not enjoy their legal monopoly regulated by the judiciary and police apparatus. What I am saying against them is nothing compared to what they do in practice. It is clear to me what their social function is in this society and whose side they are not on.