Rosenhan and the inversion of pathology
Psychology, among many other branches of knowledge, is a useful tool when associated with the need for practicality of thought. A link between thought and action. When I taught technical courses on mental health to students aged between fifteen and twenty-three, to train psychosocial support technicians, teaching the subject of General Psychopathology, I remember the faces of some of the students, divided into first, second and third year classes. I built all the manuals myself, as well as the assessment tests. In informal conversations, I could understand that there were misconceptions in many of their minds about the subject of psychology. And we talked about the history of psychology, before we went into general and specific psychopathology. Among these ideas, two or three were the most closely linked. Psychologists were a kind of wizards who wanted to extract from them the secrets they kept, the other is that they were useless when the situations were really serious, or worse, they always arrived late, referring to episodes of suicide, which most of them knew, punctually, between their generation and that of their brothers. As the topics were discussed, I could see their interest decrease or increase, depending on the topics. What he knew was that everyone wanted to understand his weaknesses and strengths, his light and shadow, as well as that of others, and that was enough to whet his appetite. And if at first I seemed rigid to them, because I wanted to define the social roles that we all played in a classroom, they relaxed as they saw me as one of them, a student, who although required work, dedication and education, they had to address me using the "you" and never "tu", they saw me do the same with all of them, I addressed them all as "you", I always tried to make them understand and not memorize the material. Using practical cases. Using films, documentaries and debates. Study visits. Reports. Tests. Monitoring internships and clarifying doubts.
I never told them I was out of love with psychology. But it was. That my passion for the subjects stagnated when, in practice, the model or theory that I taught them in the historical context, about the success of multidisciplinary teams, did not work or fell short so many times. The model told us that the focus was on health and not on illness, hence the possibility of rehabilitation of pathologies, leading institutionalized patients to be reintegrated into society, with complementary support from teams, in their respective social and labor reintegration. That in the case of addictions, investing in primary, secondary and tertiary prevention would produce miracles, that promoting good habits, associated with these preventions, would prevent unwanted pregnancies, venereal (sexual) diseases, that socialization and compulsory schooling would prevent unemployment, the use of escapism, the risk of double diagnoses, via chemical dependency, in short, that the multidisciplinary team composed of various elements, from the psychiatrist to the psychologist, from the nurse to the nutritionist, from the social worker to the educator, would all change the course with which mental illness (or mental illness) would be treated. The model was correct, its application left something to be desired. They forgot to mention that institutional vices and connections, competitions between professionals and animosities would not be considered and that patients would not cease to be subject to the xis or ypsol process, the diagnosis of psychosis or major depression, and, as a last resort, the person would always be at their own risk. Despite the good will of many, the model that is still in force and is producing ambivalent results, it is said that due to a lack of economic resources or human resources, or any other lack, is what we have. It is not the model's fault, nor the patient's fault, nor the disease's fault, nor health's fault, nor money's fault, nor competition's fault, and even less so competence's fault. What was not considered by the model is that we are all equal, all human, all too human, and error is part of progress, in the process. Remove the pretense of being gods, of being physically immortal, of the pomp and arrogance with which the social classes dress themselves, remove clubism, populism, slavery to beliefs, flattery to the opulent, privileges and all the isms and red carpets to the poor, we will all end up, lying in the oval or rectangular box, on the pyre, or in the ditch, the game of life becoming confused in the deception of death. For mental and physical health to operate on a generalized level, we would have to love our neighbor as ourselves, and we don't even know how to do that, and if we do, we stop there, because it's up to them to love the other person's navel. We must look at the world from a health perspective, yes, but understand and explain the mechanisms (coping strategies) and the preciosities (adequate knowledge tools) and focus on the globalization of well-being. I've heard a lot of good people talk about altruism, but I've seen few people practice it. And the clichés of empathy are being fueled, but cronyism continues, marginalization takes place every day, just look at the employment centers, the courts, the chambers, the parliaments, full of people full of good will. The vast majority of students on the vocational path are young people with expectations for a bright future. Many of them, if they could, would be in college, in the theater, in mechanics' shops, on football fields, on car tracks, driving balloons, making movies, cooking, managing teams, teaching, gardening, singing, dancing. When did we start castrating humans?When did we install the manipulation or abduction system on the planet? Was it when it was discovered that we could live better than each other? It was certainly when it was discovered that medicines that do not cure and, on the contrary, make humans sick, but keep patients loyal to the sweet illusion of prolonging the cure, which is the choice between removing the tick or becoming immune to ticks.
We need to look with a certain clairvoyance, at that part of us called intuition and that takes us to the inner knowledge of ourselves. The pure rationalization of the psychological and psychopathological system needs another perspective, less technical, more comprehensive, more intelligent and less bureaucratic. To change the collective social, we need to look within. Who we are, why we are, who makes us the way we are. Finding the "key" to this inner self that can make us accept that we are all equal within the differences that make us unique and that we all need to fit into the collective reality, in which we feel represented. That psychopathology is not a place of exclusion, nor of labels, nor of kings or beggars. That it is up to everyone, each one of us, to intervene in collective change and that we can only do so when we finally realize who we are, with our virtues, defects and traumas. The change we want to see reflected in the whole must be seen and operated within ourselves. That easy judgment leads us to limitations, that it makes us, most of the time, project our fears and parts of ourselves onto others, that it does not promote change, but rather the continuity of what we intend to change (reverse psychology can be an example of this, which, among other fields, coexists in marketing), in relational fields, and that it does not always translate into added value, that stigma resembles a sign of intransigence against difference, when what we should care for and safeguard is this difference and respect for it, that helping others is the ability to extend understanding to a broader field than the limit of our navel, that is, empathy and compassion are, without limits, richer, more satisfactory resources, guaranteeing effective therapeutic results, as well as dialogue and openness to social progress and improvement and that, by converging with others, we are, once again, expanding the field of possibilities in our own lives. It's a question of affective relational mathematics. A sum that adds and does not subtract. And that is also psychology, not only methods, theories and techniques, but also what is not seen and must be present, the humanization of psychology for the equation of reducing collective psychopathology. If being healthy, physically or psychologically, means opening the mental field to understanding ourselves and others (the gestalt of the biopsychosocial being), the particularization of symptoms should be the sum of the parts, which would not require a diagnosis that is reductive, but rather a prognosis and commitment, much more conciliatory and positivist. When going through the uncertainty of the future, the insecurity and fragility of an adverse environment, the competitiveness of the unknown, we are all the same, resilient or incapable. What makes us unique and develops motivation in us will sponsor mental health. And if, by transforming the tip of the iceberg of the social fabric, where dramas develop, we manage to de-dramatize the environment, we are promoting health, transversally. And, after all, what I didn't tell my students and should have said is that I don't like to see progression in mental illnesses, and psychology associated with other isms has within itself the capacity to exert positive change in the environments in which we circulate. I believe in the remission of pathologies, given our unlimited capacity to develop compassion and empathy in the future.
We are not just what you see, we are not limited. We need to humanize society through a less clinical (less cynical) and more realistic, less prejudiced and more humanistic perspective, if we want to build healthy societies. And we have the intelligence to do so. All we need now is commitment and will. Perhaps the enormous figure of humanity raised to the power of the divine within us. Prefacing António Lobo Antunes: "We are very large, very long houses. It is as if we only lived in one or two rooms. Sometimes, out of fear or blindness, we do not open our doors."
Daily News (2004) António Lobo Antunes
Comentários