File spoon-archives/deleuze-guattari.archive/deleuze-guattari_1998/deleuze-guattari.9810, message 283


To: letters-AT-laweekly.com
Subject: Re: "Quiet Tragedies"  LA Weekly,10/23-29/98, pp.36-39
Date: Mon, 26 Oct 1998 21:09:16 EST


DEAR EDITOR,

Your "roundtable discussion" about mental illness, entitled "Quiet Tragedies"
is banal for the way it rehashes presently dominant cliches about mental
illness, shaping the discourse to disclude other viewpoints on those
physio/psycho/social alienations frequently referred to as "mental disease."

The opening is alarming in the way it closes off dissent and tries to bring
the reader into the fold. "We now know that these conditions are biochemical."
Who's "we"? I am most certainly not included in this "we", nor are the
multiple thousands of others who differ. And we "know"? Well, that makes it
sound as if it is established beyond a reasonable doubt. Funny, I don't
remember being called to jury duty to decide that. Perhaps the jury selection
was slanted. A retrial may be called for. And the notion that these conditions
are "biochemical" appears to be making some sort of bold claim when in fact
nothing could be more mundane. To think "I am going to go to the store"
involves biochemistry. To feel a fleeting emotion of love for your spouse
while you are running errands involves biochemistry. To feel yourself in the
midst of a storm of passion involves biochemistry. This has been firmly
established since William James who asserted that every state of consciousness
has a corresponding biochemical state. So all this tells us is that the realm
of consciousness and biochemistry are in a dynamic interrelation. But since
consciousness itself is in a dynamic relation to the world, this complicates
issues. The world includes present sociohistorical conditions, includes our
relations to others, includes nature and our degree of communion or alienation
therefrom. It seems increasingly obvious that by stressing the "biochemical"
what is being attempted is a radical bracketing or shelving of the "world"
component of the equation, which is dangerous. The modernist assumptions in a
medicalization of all madness is frightening, especially in the way it
silences other dissenting voices including antipsychiatric voices which
contrary to media coverage did not end with R.D. Laing and David Cooper in the
70's, but continue to this day. 

The idea that "schizophrenia" IS -- note the Aristotelian "is" -- "a physical
brain disease" that "we have to accept" confuses the issue that there is no
real clear diagnostic for schizophrenia as an entity. American criteria differ
from British criteria differ from all sorts of other systems.

Please don't get me wrong ; there is no doubt that complex and sometimes
vicious feedback loops can occur between an individual's biochemistry and
their relation of consciousness to the world and their situation. The brain is
a chaotic system whereby certain biochemical tendencies can further reinforce
those tendencies, just as rain upon a muddy hill tends to carve out certain
grooves that then reinforce water further flowing down those pathways. And it
may be that there are certain chemical substances that can be introduced to
help knock the brainflow out of these ruts. However, A) Such chemicals always
have a number of so-called "side effects" (this term should be questioned,
they are effects just as much as the supposed "main" effect) which are
important to evaluate, especially in antipsychotic drugs which can cripple
those who have been subjected to them, and B) our knowledge of the complexity
of brain biochemistry might as well be in the Stone Ages. This is not to
insult the scientists who are doing incredibly creative work to investigate
this part of the equation ; it is merely to enter some humility into the
record of where we stand in relation to where we may find ourselves. Brain
chemistry is an entire ecology. The real questions come in relating this
delicate ecology to the ecology of the individual's life and life choices, the
family and sociohistorical ecology, and the ecology of the natural environment
in which all of those take place. Multimilieu ecological interaction.

There's also a confusion in this article between poverty and mental illness.
This should come as no surprise to anyone familiar with Foucault, as he and
others have charted that this is a confusion rampant since the beginnings of
psychiatry. Our society needs to develop solutions to conditions of poverty.
Many of those who are poor (surprise, surprise) are also troubled. The
socioeconomic question of how to help out those who are impoverished in their
choices and their ability to function within a capitalist socius should
perhaps be analytically separated from questions about how to help those who
are troubled and in emotional and mental turmoil. That way upper middle class
paeans about the horrendousness of "eating out of dumpsters" could perhaps be
avoided. Dumpster-diving, scavenging, etc. has long been a vocation of many
individuals, poor or not. Free food is free food, and should not be equated
with mental illness. 

Our society needs to reexamine its historical relation to gypsies and other
nomadic folk before we can really come up with a creative solution to the
problems of poverty and mental illness that do not impose a preconceived norm
or notion of "health" upon a multiplicity of lifestyles. The bourgeois
assumptions in this article about what sorts of lifestyles are healthy and
appropriate reek from the page. This is not to romanticize other lifestyle
choices. Many other lifestyle choices by necessity of the fact that they are
marginalized also face impoverished conditions. But to fail to see the
creativity in the reappropriation and detournement of the shopping cart, the
marvelous theatre of "garlands in his hair and radio antennae" is to miss out
on vital singularities that madness births, even in the midst of misery. The
psychotic "break" is often an attempt to "break out" of constrictive and
strangling norms. This is not to say that the mad consciously construct these
breaks as some sort of nonconformist art, but rather to say that the
unconscious is itself a differentiate artist that will use multiple strategies
to live the life streams the individual brings together into a nexus. Often
times these multiple strategies emerge out of desperation, for necessity is
the mother of invention. When these "breaks" or "schizzes" occur, they are
often dense, cubist, compressed, and confused. But it may be possible to help
midwife an unconscious art into a more conscious art of differentiation. It
would behoove us all to give a good historical reexamination of our relation
to the mad.

Why is the biochemical model dominant in this historical period? That's
relatively easy to demonstrate. Such a model is profitable for pharmaceutical
and medical interests, thus gets more funding for advertising, promotion, and
media coverage. Those who have dissenting viewpoints simply don't have the
campaign managers to get their viewpoint into the mainstream media. So by
simply flooding the public awareness with one model, we make it seem as if
that were the only model a sane , modern person would accept. As if even the
biochemical studies weren't subject to multiple interpretations from multiple
models!

Mark Ragins makes some excellent points when he encourages a more
phenomenological approach of "seeing the world from my side instead of from
yours". The dominant model of psychiatric intervention is analogous to the
policy of nation states towards terrorists : to refuse to negotiate, to
dictate terms, to neutralize the problem. The whole notion of dialogue and
interaction has been taken out of the picture. Maybe because the so-called
"delusions" or alternative per/con/ceptions of reality their clients are
experiencing are too foreign for them to relate to and make them
uncomfortable. It's curious that psychiatric training includes no exposure to
changing set across different interpretive channels. It would behoove
practitioners to expose themselves to a wide variety of beliefs, so that these
beliefs don't seem so bizarre or unacceptable. In context, most of these
delusions make "sense", meaning they have consistency. People are natural
scientists. They make hypotheses to explain phenomena they are experiencing,
and their hypotheses usually emerge from things they know about in their
experience. So "delusions" are usually attempts to explain anomalies using
known categories. We can help such people by entering into the anomaly itself
and finding alternative hypotheses, perhaps hypotheses that are even
falsifiable, and by validating the possibility of the delusions, but wanting
to assess their probability. Certainly in the 90's we know that the CIA and
FBI DOES follow people, there's ample documentation on all sorts of spying
activities, so for a person to reach out to this knowledge to try to explain
anomalies in their experience is not so unusual after all. In fact, it may
make perfect sense. The question then becomes one of determining whether the
FBI is actually spying on one or whether there is a more elegant way of
approaching the problem. How many psychiatric technicians have actually gone
to the trouble of figuring out whether they themselves are being watched by
the FBI? But why ask questions or upset your own sense of reality when you
could simply dispense a pill?

The idea of "forced treatment" "making sense" simply allows deviance to be
dealt with coercively. Why not medicalize everyone who differs from the norm?
After all, it's often a very grey area between the realms of "eccentricity"
and "madness", between radical differentiation and "psychosis". If we want to
institutionalize Reality Police, let's be clear about the fascism this
implies, no matter how "do gooder" it may seem.

Is anyone questioning the sadism of professionals like Amenson who exposes
fantasies of tying his son up in a room, of sprinkling meds on his Post
Toasties? When professionals start speaking in this delirious sort of manner,
we need to really question who it is who truly has the delusions. I hope that
the abusive metaphors implied in the statement that "as a father I would strap
him in a room and do whatever I had to do" are troubling to Weekly readers.
This is psychiatry at its darkest and most intrusive.

I sincerely hope that the Weekly will welcome dissenting viewpoints to this
article. It is frightening to think that this coercive and overly
pharmaceutical model is being touted as some sort of "roundtable" that
comprehensively covers the issues. With forced medicalization on the agenda,
"kindness" cannot mask the attempts of the dominant privileged to impose their
worldview and interests upon any who differ.

(un)leash

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