When I started university in 2007, I didn’t know it would turn out to be so lonely. For me, becoming a psychologist was mostly about the very serious business of understanding everything about the human mind, and having answers that nobody else had. Psychology was a science and I remember very well that I thought I could master it completely.
I spent seven years in school, studying every approach and reading about many theories. I have been taught about diagnosis, psychopathology, treatment, evidence-based practice, CBT (and its efficacy of course), research methods and so many other things that were supposed to help me in my professional life.
Now, professional life has arrived. I’m a certified psychologist. I have spent the last year or so speaking with people about their lives, their fears, their problems, their hopes and their solaces. It’s a great job, as fulfilling and full of bliss as I had expected. But every single day, when I try to understand and sometimes help people who enter my office, I have the same reflection.
This is not what I have learned in school.
Psychotherapy (I’m still searching for a better term, since the word ‘therapy’ involves thinking that there is sickness somewhere) is not about knowing everything. It’s about humanity, doubts and uncertainty. It’s about reaching out and reaching in, authenticity and honesty. It’s the most demanding thing I have ever done, because I’ve fully involved myself in this work; I use my own feelings, scratch away at my existential issues and try to care as deeply as I can for people who choose to enter my office. Sometimes, I know exactly what helps and what doesn’t. Sometimes, I have no idea. In a very odd way, it’s the most professional attitude I can think of.
But it is also the lonely way.
I feel lonely every time I read the newspaper, because most discussions about mental health revolve around diagnoses and illnesses. Nobody seems to realize how silly it is to use statistics and measurements for invalid concepts. Yet when I try to explain this, I always feel clumsy and obscure, as if someone had stolen the right words to speak clearly about those things.
I feel lonely every time I speak with colleagues. Over the years, the vocabulary of mental illness has become completely obsolete to me. I realize I don’t need to use it with my clients (luckily, in Québec, most insurance companies don’t demand an official DSM diagnosis for reimbursement). Part of this model’s weakness is its explanatory power, since it rarely takes personal history into account. The fact that emotions, thoughts and behaviors are transformed into “symptoms” makes no sense to me, a sad mockery of medicine based on the personal opinion of so-called experts.
I know that, if you’re reading this, chances are you know exactly what I’m talking about. Mad in America has been my ideological refuge for a long time, full of bright ideas about how things should and could be different. But most “clinical discussions” I am a part of use the words of the DSM as foundations for comprehension, diagnosis and treatment. I shouldn’t be surprised, after all this is what was taught to me in university. This is what is promoted in institutions all around North America. So, when I speak my mind, as I said, I feel very lonely.
I want to fight back and do something about this. I have turned down two job offers because of my ideas. I don’t want to stop being idealistic, and I hope I will forever be too young for that. At the same time, challenging the existing model is not easy. Powerful and respected people have built careers and lives out of these concepts. I’m searching for a way to tell them it has no scientific value and has caused more harm than good. I’m searching for a way to make a whole system realize it has been living in cognitive dissonance for a very long time. I want to do this without an open war, without a useless confrontation of egos.
So, I keep walking the lonely way. This text is an attempt to get a little company on my path.
I have started a book project. (It’s in French, by the way. Another obstacle on my route is the fact that many people in Québec don’t read or understand English very well.) I’m calling it “Porter Préjudice”, and I will offer you the pleasure of finding out what it means by yourselves. I have divided the book in ten chapters, each of them exposing a lie of the medical model. Here is a preliminary chapter list:
- We can establish valid diagnoses in mental health
- The progression of science is what allows us to better recognize, diagnose and treat mental illnesses
- A chemical imbalance in the brain is recognized as the origin of mental illness
- Psychiatry has always been a medical discipline using good science and proven techniques and treatments
- We understand the mechanism of action of pharmaceutical drugs mechanisms and we know they have a positive effect in the long-term
- Pharmaceutical companies and professional associations use objective science in the development and marketing of their products and treatments
- Depression is a discrete illness (a neurobiological or neurodevelopmental disorder) and antidepressants correct a chemical imbalance in the brain
- ADHD is also a discrete illness and stimulants work to correct a chemical imbalance in the brain
- There is no alternative model to the medical model
- People who critique the medical model have no empathy and deny the suffering associated with those conditions.
I know, that looks like an all-you-can-eat menu. I tried to remain more specific, but there is so much to share on this subject that I couldn’t reduce the list any further. If you think you can help by pointing out useful information, sharing ideas or even writing something about any of those chapters, please feel free to contact me. I would be very happy to get any help you can offer.
The biomedical model is taking away humanity from us. By transforming our emotions into “symptoms” we have to numb, it takes resilience away. By transforming our thoughts into “symptoms” that need to be put back in the box of “normal”, it takes creativity away. By transforming our behaviors into “symptoms” that need to be fixed so that we can all be the same “normal” beings, it takes diversity away. We will need those things in the next few decades more than ever before in the history of humankind. I choose to fight this model with all my heart because I refuse the world it implies. I walk the lonely way every day, hoping it can make all the difference.