Thursday, May 7, 2009

The trouble with institutions, Part II

Modern science, according to German writer Hermann Hesse, is in the Stone Age compared to the teachings of ancient Indian mythology. I'm sure he's right.

Dr. Vandemaele, Chris's psychiatrist at the time, felt that Chris was on the upturn and would be ready to be released from the hospital in early March, 2004. Based on Chris’s reported symptoms and the doctor’s clinical observations, Dr. Vandemaele was of the opinion that Chris had schizophrenia, with a secondary depression, the two together not uncommon in the first presentation of the illness. Dr. Vandemaele assured us that there are effective treatments for both conditions and we could expect Chris to continue to improve with the initiation of the antidepressant. I did not disagree with Dr. Vandemaele’s assessment that Chris had schizophrenia and was also depressed, but to me it was situational depression, prompted by being forced to drop out of university while residing in a mental hospital. To Dr. Vandemaele, depression was a medical thing that could be treated with drugs.

To a doctor working in a psychiatric institution effective treatments mean medication. The institutional doctor does not convincingly project to the patient or the relatives a belief that the patient will eventually be capable of functioning in normal society, probably because the doctor does not work with normal society. His belief system comes from a conservative medical training and what he sees on the psychiatric wards. He only sees the breakdown within the walls of the institution.

For decades, psychotherapy has been downgraded as an effective treatment for schizophrenia in favor of drug treatment. Many people did not benefit from this treatment because it was considered of little therapeutic value when it came to schizophrenia. Dr. Vandemaele spoke of effective medications and did not speak of psychotherapy except to turn that job over to Chris's priest.

R.D. Laing was one psychiatrist who understood. "Madness need not be all breakdown. It may also be break-through. It is potential liberation and renewal as well as enslavement and existential death." This sentiment may have been echoed by Dr. Vandemaele, but if it was, he never shared it with me. I could have used the encouragement and the hope in this very dark period. Instead, the language of the institution and the staff was psychosis, comorbid symptoms, prodromal symptoms, effexor, respiradone, etc. These words are terrifying.

1 comment:

  1. Thank you for sharing these very encouraging comments. Having been diagnosed schizophrenic 20 years ago and suffering the effects of medication i want to wholeheartedly affirm your belief in Hesses position. It has been an agonosing journey for me but a lot of that agony has been caused by the misunderstanding of professionals. I am now drug free and continuing on my journey of self discovery. I wish you and your son well.
    Best Wishes


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