But I realized something. About art. And psychiatry. They're both self-perpetuating systems. Like religion. All of them promise you a sense of inner worth and meaning, and spend a lot of time telling you about the suffering you have to go through to achieve it. As soon as you get a problem in any one of them, the solution it gives is always to go deeper into the same system. They're all in rather uneasy truce with one another in what's actually a mortal battle. Like all self-reinforcing systems. At best, each is trying to encompass the other two and define them as sub-groups. You know: religion and art are both forms of madness and madness is the realm of psychiatry. Or, art is the study and praise of man and man's ideals, so therefore a religious experience just becomes a brutalized aesthetic response and psychiatry is just another tool for the artist to observe man and render his portraits more accurately. And the religious attitude I guess is that the other two are only useful as long as they promote the good life. At worst, they all try to destroy one another. Which is what my psychiatrist, whether he knew it or not, was trying, quite effectively, to do to my painting. I gave up psychiatry too, pretty soon. I just didn't want to get all wound up in any systems at all.
I decided early in graduate school that I needed to do something about my moods. It quickly came down to a choice between seeing a psychiatrist or buying a horse. Since almost everyone I knew was seeing a psychiatrist, and since I had an absolute belief that I should be able to handle my own problems, I naturally bought a horse.
If there is one central intellectual reality at the end of the twentieth century, it is that the biological approach to psychiatry--treating mental illness as a genetically influenced disorder of brain chemistry--has been a smashing success. Freud's ideas, which dominated the history of psychiatry for the past half century, are now vanishing like the last snows of winter.
On Prozac, Sisyphus might well push the boulder back up the mountain with more enthusiasm and creativity. I do not want to deny the benefits of psychoactive medication. I just want to point out that Sisyphus is not a patient with a mental health problem. To see him as a patient with a mental health problem is to ignore certain larger aspects of his predicament connected to boulders, mountains, and eternity.
Imagine a society that subjects people to conditions that make them terribly unhappy then gives them the drugs to take away their unhappiness. Science fiction It is already happening to some extent in our own society. Instead of removing the conditions that make people depressed modern society gives them antidepressant drugs. In effect antidepressants are a means of modifying an individual's internal state in such a way as to enable him to tolerate social conditions that he would otherwise find intolerable.
Macbeth: How does your patient, doctor?Doctor: Not so sick, my lord, as she is troubled with thick-coming fancies that keep her from rest.Macbeth: Cure her of that! Canst thou not minister to a mind diseased, pluck from the memory a rooted sorrow, raze out the written troubles of the brain, and with some sweet oblivious antidote cleanse the stuffed bosom of that perilous stuff which weighs upon her heart.Doctor: Therein the patient must minister to himself.
A little later, when breakfast was over and I had not yet gone up-stairs to my room, I had my first interview with Doctor Brandon, the famous alienist who was in charge of the case. I had never seen him before, but from the first moment that I looked at him I took his measure, almost by intuition. He was, I suppose, honest enough -- I have always granted him that, bitterly as I have felt toward him. It wasn't his fault that he lacked red blood in his brain, or that he had formed the habit, from long association with abnormal phenomena, of regarding all life as a disease. He was the sort of physician -- every nurse will understand what I mean -- who deals instinctively with groups instead of with individuals. He was long and solemn and very round in the face; and I hadn't talked to him ten minutes before I knew he had been educated in Germany, and that he had learned over there to treat every emotion as a pathological manifestation. I used to wonder what he got out of life -- what any one got out of life who had analyzed away everything except the bare structure.
Steve [sports psychiatrist] had already taught me to try and stop worrying so much about pleasing everyone. We knew that this was one of my most draining flaws and he again used three groups to clarify my thinking. There would always be some people, Steve said, who would care about me and love me. In contrast there would also be a select group of people who would never warm to me - no matter what I did. And in the middle came the overwhelming mass who were largely indifferent to any of my failures or triumphs. I needed to understand that most people didn't really care what I did or said. All my anguish about how they might perceive me was redundant. Steve helped me realize that I spent too much time trying to please those oblivious people in the middle or, more problematically, the small group who would never change their critical opinion of me. I should concentrate on the people who really did show concern for me.