I blame modern medicine
The story of an employee of one of the Moscow clinics: “She’s 11 years old, my granddaughter. And it almost all his life complained that her head hurt. Then she had the voice she had heard. But we long not speak about it and only then began to complain. Told me that hears my mother’s voice, if we yell at them. Two months treated. Here, and now all glory to God.
In the treatment of this girl I used psychiatric drugs, and harmless songs, as if pieces of protein molecules that have no relationship to psychotropic drugs. As you can see, it was enough to get her back to normal life. Now let’s try to dream, what would happen to this child if her parents went the usual route and took the daughter to a child psychiatrist.
So, early infantile schizophrenia. This is the diagnosis that immediately arise in the mind of doctors. Is hospitalization in a psychiatric hospital. It is the neuroleptics. Antipsychotics in a child of ten years will cause depression of the main functions. It would be difficult to think, difficult to say. Disturbed coordination of movements. But the voices that she heard, too, will disappear. Come grandmother, herself a nurse, to the doctor and say, “but what is it? Granddaughter-I have some other”. She will say: “what do you want? Such a serious illness”. Will deoccupied from a mental hospital, leaving on the same antipsychotics. Somewhere in six months she will not be able to attend school because she will come the trouble with concentration of consciousness. Grandma sounds the alarm, again it will go to psychiatrists, they’ll say, “Oh, what a serious illness!” and change the antipsychotic. In the best case. In the worst — will simply increase the dose. The child adapts a little, but would be odd. It is very possible that I will begin to ramble, go under. A few months grandmother again come to a psychiatrist, who again shook his head — a serious illness, poor girl! and again change the antipsychotic. Or will not change, and will increase the dose. Then the girl grows up, she will start her pubertal crisis. And there is not one doctor who decides to cancel her antipsychotics during puberty crisis because it is believed that mental illnesses have painful deteriorate. Because of the constant use of neuroleptics girl will be in “zombie” state. She will be deadened emotions, it will be tight to think. Sometimes it will sort of strikes, trying to interrupt the treatment. To cope with this, it again for some time put in a mental hospital and so on. And it will last a lifetime. This vicious circle get 90% of the people identified for treatment in a psychiatric hospital. And all because the average Russian psychiatrist not and do not want to do anything except the appointment of neuroleptics. They usually say: “I’m not a therapist, I am a psychopharmacologist.
In General, what the Russian psychiatry? In my opinion, her story should be counted since 1836. It was the year when the magazine “Telescope” Petr Chaadaev published his first “Philosophical letter”. The result of this publication was that Tsar Nicholas I had declared to the Russian people that Chaadaev was crazy. And this fact instantly and happily recognized psychiatrists. That’s the most important thing that can be said about the Russian psychiatry. Further all developed under the same scenario. If in the 1920-ies the labour force was not enough, the state needed a little mental patients and then the diagnosis was made little. In the seventies, when declared universal employment, on the contrary, it was advantageous to hide people in the hospital, so they do not spoil the statistics and diagnoses were placed in terribly large quantities. It would seem like you could manipulate the diagnosis? Because the disease is either there or it is not. Let’s face it. The basis of modern psychiatry is the so-called “German school”, which are considered classics of Emil Kraepelin and Karl Jaspers. The systematic work of Jaspers in General psychopathology, in which he described all known psychiatric condition, is considered to be basic. But forget about what Jaspers had in mind not only a description but also a method. He believed that man has only one way to understand the other person — it is necessary to find an analogy in itself. Here before me, say, a girl sitting and picking at the fringe of her shawl. I don’t know what she feels. But can throw upon his shoulders the shawl and try to realize that person feels how I feel! when you do this.
To work on this method, the doctor must continuously expand the world of their own feelings and attitudes. It is quite possible, but it’s certainly a great spiritual work. Something like do the actors. But the actor does not have to make a judgment about the extent of patholo-gical condition that he plays, so it is a little easier. And for a psychiatrist here begins the hardest thing, which is called “psychodynamic approach”. It’s a model of chuvstvovany in the patient.
Some similar relationships have patients, going to a psychiatrist, to this day. But nothing like this happens. In Russian psychiatry is mainly used more simple nosological approach. And still in our country in order to put a psychiatric diagnosis, do not need any survey data, no need to try to get into the skin of the patient. I just have pictures from psychopathology to choose some suitable one. For this I have to play the role of a journalist. I’m in the medical history needs to describe the mental status of a person sitting in front of me. His emotional state, facial expressions — in short, all what I can say about his current condition. From this description and from it, emerges a diagnosis. So it was in the seventies, and is still so. Under the diagnosis should be three signatures, that is, two more doctors to agree with me. At the same time, it is likely that these doctors the patient will not be watching, they’ll just read my description. After that, the diagnosis is final, and even to challenge it in court would be impossible. I repeat: no EEGs, no psychological tests, no tests, nothing for setting the diagnosis. Only need my opinion on you. Very roughly speaking, I need to see you in one of the two psychiatric diseases. In one case, a schizophrenia, in the other case, manic-depressive psychosis. Well, there is a epilepsy, but in the Moscow psychiatric school, she is hardly considered. To see the symptoms of these diseases very easily.
I’m not saying that in fact, mentally ill people do not exist. Here, in my opinion, the rule of three percent. 3% of people who come for treatment with the diagnosis “alcoholism”, in fact, suffer from alcoholism. 3% of people who come for treatment with the diagnosis “schizophrenia” really suffer from schizophrenia. Everything else is a condition which are caused by some kind of clear organic processes in the nervous system, or those or other psychological experiences. Including, among other things, conditional benefit of the disease. Because the disease is a condition that deprives a person of responsibility. You can live for years in a mental hospital is not very nice, but much easier than living in real life. What to do the doctor in this situation? To try to reform a person or to accomplish what he wants, leave him to his bunk in the hospital.
I had become a specialist in the lifting of neuroleptics. It’s insanely thankless task. Because people besides that get some direct changes in the nervous system for years because of these drugs, they also put your life at the time of treatment. Here we have a man who had no experience of teenage experiences, was not the first love, there was nothing of what we call “psychological growth”. And if we suddenly decided to remove him from neuroleptics, terrible things happen, because for several years this person must live all that we live for decades. The psychiatrist helps him in this, and it’s a hell of a job for both. And not every psychiatrist it will be resolved, and not every patient.
To change anything in today’s psychiatry are very difficult. For UNESCO, the state of psychiatry is one of the criteria of culture. The level of relationship to the mentally ill is judged by the level of culture of the country. We have here nothing qualitatively has not changed and is unlikely to change in the coming decades. In order for something has changed, no orders and decrees will not help. We need to raise up a new generation of psychiatrists. There must be a new school. Needs to radically change its approach to the teaching of this discipline. Needs finally to come from somewhere new teachers, because people, who for 25 years has read the same lecture about schizophrenia, you will not be able to read a lecture on the psychodynamics. Of course, there were some progressive things. The law on psychiatric care, of course, is a progressive thing. But in reality nothing changes. Because the real change is the change of attitude of professionals. And we’re still waiting. Here we have adopted an international classification of diseases, called ICD-9. It has almost no schizophrenia, and it’s the same 3 %, and put it under this classification is extremely difficult. However, the majority of Soviet psychiatric schools reported that “we hold different views”. And that’s really the existing classification, which severely restricted the formulation of the diagnoses, did not change anything.