How To Be Treated For A Mental Illness You Don’t Have

The Strategy of Bait & Switch

The Imaginary Invalid (by Honoré Daumier 1857)

Take the following everyday situation. Someone suffering from anxiety or any negative feeling — disordered thoughts, stress, depression, etc. — makes an appointment to get help from a doctor, psychiatrist, psychologist, or otherwise. The person complains of a symptom that interferes with their life, makes it false, if not impossible. Since there is no necessary condition for a mental symptom to be produced by a physical cause — a chemical imbalance, lesion in the brain, etc. — a mental health expert can only offer a possible therapy and treatment¹. To implement a possible treatment, it has become standard to actually create an artificial condition for an illness to occur or not, then attempt to treat the consequences of this artificially induced norm — not the actual mental symptom in reality².

For example, 40 years ago the hypothesis was made that a lack of serotonin corresponds to a depression and that one can artificially introduce a higher level of serotonin with the prescription of pills — Zoloft, Prozac, Paxil, etc. — to fix this imbalance. Once this artificial condition of a higher serotonin level is created, the treatment consists of managing the reaction of the patient to this new artificial norm.

What is being treated in such a possible therapy is not the actual abnormal symptom the patient walked in the door with, but a hyper-normal symptom — what any John or Jill Doe may have physically — as induced by the research model of the treating doctor³. And again what is being called treatment here is only a possibility, not a necessity; it is a remedy, not a cure, it is a way to manage a symptom, not to found its theory. Although such remedies often disappear as fast as they are invented in the medical community, they tend to linger in the general population as fossilized hope⁴.

The advantage with such possible treatments is that they may give some relief and hope: if before someone was living with the anxiety of the unknown, now it is known.

The disadvantages are that if before it was not sure whether you were physically sick or not, now you are, if not in fact, at least, in principle, since it is well known that someone cannot keep taking psycho-tropes indefinitely without harmful side-effects.

The wager being that once a possible mental illness is given an empirical model, it becomes manageable in the short term, while waiting and hoping for something in the long-term besides the debilitating side-effects. The question as to whether there is a more necessary way of proceeding will be left to Part II.

Though there are numerous possible treatments of different mental symptoms from depression and anxiety to psychosis, what remains invariant is a Bait & Switch strategy:

If you have a mental symptom, a mental health expert may not be able to treat it directly, but you can be given a parallel illness with a physical condition that then becomes more manageable.

Though the strategy is general, one of the most infamous examples is the case of lobotomy and shock therapy being proposed in the last century as a cure for anything from schizophrenia and depression to homosexuality and communism. That the inventor of lobotomy, the Portuguese neurologist Dr. Moniz, would receive a Nobel Prize in 1949 is just one indication of how easy it is for forms of manipulation and abuse to become possible treatments once generalized onto the public as ‘care.’

Indeed, the Bait & Switch strategy extends further if one refocuses it in the field of politics and modern-day warfare. The U.S. may not have been able to cure Iraq of Saddam Hussein and his regime, but what the Bush government could do is give Iraq a more significant problem: bomb and decimate an ancient civilization to the ground, with all its tyrants and atrocities, in order to commit a larger and more well known atrocity. For it is precisely because of this more real and normed act of violence that the situation becomes more manageable — at least for the liberators under the hope for freedom and justice.

I n the end, the hyper-normal model is easy to identify:

You can get help today even if you have nothing wrong with you; if you do not have a physical illness you can always be given one to be ‘better’ treated.

Without denying the hope or relief such possible therapies may bring, one should also ask at what point do they become irresponsible to the point of not only inducing a social psychosis but forms of criminality.

I close here with one example among many of the digression of a possible treatment into a paranoid psychosis that appears all too normal today.

Many people today who have sought help with depression and become convinced for one reason or another that their depression is a physical illness, speak of it in paranoiac terms.

For example, the writer of the Medium article, Depression Doesn’t Discriminate, by J. S. Hulst, is just one example of a standard way today to describe a depression paranoiacally:

“Even if you do not have a history of depression, without warning, it can strike upon either the slightest or most significant change in life circumstance. We cannot immune ourselves from its reach. The frightening reality is that we are all quite possibly one life-changing moment from being wrapped in depression’s tentacles.”

At the turn of the century, psychiatrists themselves recognized that by making depression — or any other symptom — into an internal enemy that one could not escape from, that they could substantify it and prepare the ground for reducing it to a mere physical illness like a cold or heart attack. But what they then recognized, at least the most honest among them, by both demonizing and making the mental symptom into a physical illness, they had replaced one symptom with another — a paranoid psychosis which is just as bad if not worse than the original symptom. Where previously hopelessness had been perceived everywhere in the name of depression, after the physical diagnosis, the patient is seeing “frightening reality” and “ tentacles” in the unspoken name of paranoia.

Replacing one set of symptoms with another which has a physical condition and is, therefore, more manageable, is the strategy of Bait & Switch. What is disheartening today about such an approach is that right at the moment people claim to be de-stigmatizing mental illness because it can happen to anyone just like any physical illness; they are in fact hyper-stigmatizing it at a much more vast level. For in claiming a depression, or any other mental symptom, can happen to anyone just like a physical illness; depressives and non-depressives alike are now being invited to become paranoiac. Indeed, the message of the author above who claims “We cannot immune ourselves from its reach” not only de-responsibilizes people from acting to prevent a depression, but misguides them with regard to more necessary ways of working with a mental symptom.

Fall 2018

Notes

[1] For why the treatment in such cases is only possible and not necessary, see my previous writing You May Want To Try This Before Believing Depression Is Caused By A Chemical Imbalance

[2] What is today called a ‘differential diagnosis’ in a medical clinic is a diagnosis of the symptoms of various diseases where one is rarely dealing with a ‘pure’ disease but with different possibilities: for example, a cough could be both a symptom of a common cold and/or bronchitis in the hypothetical model of the doctor-researcher. What differs in the research of a mental symptom is that the models of the researcher are less conclusive: they may themselves not only be different and overlap, but contradictory. That is to say, it is not inconceivable that one psychiatrist would diagnose the same abnormal behavior a perversion, while another would call it a psychosis. Hence, the correlation to something besides a possible model is required to account for the reality of the symptom. It is this contingent aspect of reality in the interpretation of the symptom that I will address in Part II: Towards The Non-Differential Clinic

[3] To follow the use of the term hyper-normal, it may be helpful to have already read a previous writing: It Is Not A Privilege to Be Mad, A Psychopath, Mentally Ill and/or Psychosis — Hearing Voices Is Normal Today

[4] The researchers Lacasse and Leo write: “there is no such thing as a scientifically established correct “balance” of serotonin. The take-home message for consumers viewing SSRI advertisements is probably that SSRIs [selective serotonin reuptake inhibitor] work by normalizing neurotransmitters that have gone awry. This was a hopeful notion 30 years ago, but is not an accurate reflection of present-day scientific evidence.” (2005). Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLOS Medicine. DOI; 10.1371/journal.pmed.0020392.

Researcher in le temps perdu: sex, race, ethics, the clinic, logic, and mathematics. Founder and analyst at PLACE www.topoi.net

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