Insisting on the change of paradigm
JUNE 5th, 2013
Marketing specialists, who
are very knowledgeable of behavior, state that there is nothing harder to
change than habits. To those who work on everyday psychiatry, and are able to
see its shortcomings, resistance to change can shock them.
All changes of paradigms
that have happened throughout history have transcended the will and plans of
those who chased them. Against this apparent pessimism, anthropologist Margaret
Mead said: "Never doubt that a
small group of thoughtful, committed people can change the world. Indeed, it is
the only thing that ever has.”
The greatest strength of
the resistance to change is not specific, but generic: today, doctors have become
drug prescribers. The entire health system is settled around this supply and
demand relationship: those who want to recover hope that pills will solve
everything; those who manage health
have no time but to pay attention to them.
‘psychiatrized’ patients won’t lead any change: many of them are perfectly
happy with their diagnoses, for many different reasons, among them the relief
of “knowing what illness I am suffering from and what is the treatment”.
We can imagine
two very different futures:
- In one of
them, ‘psychiatrization’ has won: DSM VI offers the standards to diagnose
something to the entire human population, that is, to create a universal market
of psychotropic drugs. Huxley, in A Happy
World, concludes the same: 100% of the population receives the daily dose
of soma to guarantee their happiness.
- In the other,
maybe something happened, relevant enough to change the view of enough people;
of course, a more self-critical minority of psychiatrists, some unhappy
patients … who knows what awaits us.
Meanwhile, it is
no modest victory to play the game from the side of the prisoners: we can be on
the side of complicity and disregard, adding bricks to the wall of solitude and
oblivion, or we can be brave and persistent and tear down, one by one, the bars
of the cell.
as possible new paradigm, there is a recurring thought that has been coming to
my mind all these years. It is the lament of Wolfgang Pauli, included in Kuhn´s
The Structure of Scientific Revolutions:
"At the moment physics is again terribly confused. In any case, it is too
difficult for me, and I wish I had been to movie comedian or something of the
sort and had never heard of physics.” Logically, in my case, my discouragement
doesn’t apply to physics, but to psychiatry.