My ideological orientation is behavioral, and if you were to ask people in this business: what is the opposite of a behaviorist? you would probably get the answer: a Freudian psychoanalyst. And vice versa. They are two very different ways of conceptualizing human activity.
As a student I studied Freudian theory, and also the works of other notable figures in that field, but felt more at home in a behaviorist framework.
But I was always struck by one huge, though seldom articulated, similarity between the two, otherwise very different, systems. They both stress the need to get to know the client. They both maintain that the client’s actions can be understood if you get to know his history and his context, and they both maintain that if you don’t understand the client, it is because you haven’t gotten to know him well enough.
All of which is in such marked contrast to present-day bio-psychiatry, where the purpose of the initial evaluation is simply to assign a diagnosis and prescribe a drug. When people go to see a psychiatrist, they expect him to listen to their story, and often they think he is listening. But he isn’t really. Rather, he’s listening the way a computer listens. If you ask Mr. Google to find something for you, you know he’s not listening to you. What he’s doing is latching onto key words in your request and searching archives for matching strings.
This is very analogous to what psychiatrists do. If you mention the word “depressed” or “feeling down” in the first minute or so, he pegs you into the depression category. Next he wants to know which sub- category of depression. So he’s listening for duration words, like “every day,” “some days,” etc… He will ask questions about your sleep, appetite, etc., and it may seem like he’s trying to understand you, but he’s not. He’s slotting you into a “diagnosis.” Not that it matters much. He’s going to give you a prescription for an antidepressant. But he needs a paper-trail to justify what he’s done. There’s a particularly tragic description of a standard psychiatric interview in an article by Lori Robinson on Mad in America. You can read it here. Most of the agencies I’ve ever been associated with allotted 15 minutes for a routine psychiatric interview, and I have known psychiatrists who routinely completed these in less than ten.
So whatever ideological reservations I have about Freudian theory, they pale to nothing compared to my antipathy towards modern psychiatry, its endlessly increasing medicalization of every conceivable human problem, and its blatantly corrupting ties to big pharma.
Here’s a quote from Claudia’s paper:
“In mental health care, this shift away from the search for meaning is due at least in part to the birth of ‘biological psychiatry’ and the hope that complex emotional struggles have a simple chemical explanation that can be solved with a drug.
This is very similar to what we mental illness “deniers” have been saying. The anti-DSM camp is a big place, and there’s room, I believe, for a variety of alternative perspectives.
Claudia’s article is a little digressive in places, but Freudian psychoanalysts have never been known for terseness or linguistic economy. It’s definitely worth a look.