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.

Psychiatric or ‘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.

J. L.


Regarding hyperia 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.