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Illness/disorder/disease, are not well defined technical terms. Using these terms usually means we decide that something:
1. Is bad
2. And we want doctors to deal with it
That works pretty well for something like cancer (although it also limits our understanding of it).
(cont)
1. Is bad
2. And we want doctors to deal with it
That works pretty well for something like cancer (although it also limits our understanding of it).
(cont)
The most pressing issue when cancer is discovered is to get rid of it or suppress it. Usually. Sometimes doctors do more harm than good when they do what they're trained to do and fight the cancer, when it would have been better for the person to leave it and die peacefully.
Doctors are trained to isolate problems, to objectify them, to fix them. People who go into hospital with broken legs often appreciate this, but it can also feel dehumanising. And it makes doctors more likely to disregard the thoughts and feelings for of patients - externalities.
They're not externalities for the patients, but for doctors they are something to manage, to deal with to the extent that they don't get in the way of the important thing. To make sure the patient is "compliant" with treatment.
A lot of doctors are aware of this problem and are trying to deal with it. Usually by attempting to find ways of managing the feelings of doctors, to make doctors comply with the task of listening more to patients. A bandaid.
The medical model does a lot of harm, even in somatic medicine. The problems are mostly baked into the entire system, from requiring medical students to be wealthy academic overachievers, from having a mechanical focus on health, from profit motives, and more.
When it comes to what's called mental illness/disorder, these problems are magnified. Both in the effects they have (objectifying feelings and instrumentalising human relationships) and their application (incarcerating patients and violently drugging them).
The training that doctors have, and the way the medical establishment works, is especially harmful when the problem to be fixed is human suffering, marginalisation, oppression. Medicine is a profoundly normative, elitist, conformist, objectifying institution.
When we allow doctors to conceptualise and define different kinds of human misery, and then design ways to deal with it, we are in effect asking wealthy, privileged, people to explain and manage mostly marginalised, disenfranchised people. It shouldn't be surprising what happens.
Doctors are trained to individualise, analyse, objectify, instrumentalise, to sublimate and suck it up. They do this with themselves. It's how they got into medical school, how they endured the bullying and overwork. It's what they know, and what they are told to do.
Of course they are going to look at miserable, abused people and reduce them to things. They are going to locate the problem in the victim of abuse. They're going to look for "cures" for suffering. They're going to respond badly to "non-compliant" patients.
They're going to replicate the abuse that turns someone into a psychiatric patient in the first place. They're going to convince themselves that they're helping when they're harming.
They are not going to find solutions to these problems because they live in the institution and breathe the atmosphere that causes these problems. At most they are going to look for less harmful methods.
That's why I don't agree with the idea of mental illness. It's not a scientific disagreement, it's political and practical.
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