Friday, December 27, 2013

Bipolar Disorder, ADHD and Man’s Soul

Bruno Bettleheim
One of the lagniappes of psychoanalysis is the philosophical attitude it takes towards mental illness. There is no cure for life. In fact in Charlie Kaufman’s masterpiece Syndechoche, New York (2008) that is precisely the mysterious illness that afflicts the main character, Caden Cotard, played by Philip Seymour Hoffman. The DSM-5 offers a smorgasbord of diagnoses that offer the illusion or delusion that there is some sort of cure for mental states which is achieved by 1)naming them 2)medicating them and 3)making them insurable. This is not to say that there aren’t severely ill patients who don’t benefit greatly from medication. But these days every other person you talk to is either bipolar, ADHD or if their behavior is more over the top, borderline. And having received one of these diagnosis a buffet of medications awaits these sufferers. It’s not surprising that the Times recently ran a front page piece about the abuse of  attention deficit disorder diagnoses, emphasizing the beneficial effect the diagnoses are having on the profits of the drug companies (“The Selling of Attention Deficit Disorder,” NYT, 12/14/13). What’s most disturbing is that much of the medicating is being done willy-nilly by the worst kind of practitioners, those suffering from the arrogance of not knowing how little they know. Moliere would have had fun writing a parody of these Tartuffe’s of psychiatry. Perhaps he might have called it “Le docteur imaginaire.” When Bruno Bettleheim wrote Freud and Man’s Soul :An Important Reinterpretation of Freudian Theory back in l982, he was dealing with the American psychoanalytic  establishment’s need to use language as way of making psychoanalysis more scientific sounding. The fact is that while analysis may be quite helpful to the small number of patients who have the time and money to afford it, it’s hardly what one would classify as a scientific discipline. And that’s probably the good part. Psychoanalysis might not be the cure for ADHD or bipolar disorder, but it offers a broad view of human existence that attends to the one part of the human being that you can’t locate on an MRI or FMRI for that matter--the soul.

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