I was just reading an interesting account of "structuralist" writers. I think this ties into my critique of psychiatry. I believe that the main fault of psychiatry is behaviorism and materialism--the philosophy that nothing can be said about consciousness beyond the material, or beyond the observable. This leads to, among other things, the attitude that if certain behavior changes, the patient's wellbeing changes, because wellbeing is nothing but a set of behaviors. (For example, there was a study which claimed that Olanzapine worked because the decibel level of a psychiatric institution lowered when the patients were given the drug. The idea is, if the measurable behavior of loudness changes, the wellbeing must change too.)
I have just read an account by Dominique Janicaud which clarifies this. Psychiatrists are supposed to be scientists. Scientists are supposed to be structuralists. Structuralism, by itself, according to Janicaud, is not an ideology. It is a methodology.
The implications of this are huge. It means that psychiatrists have nothing moral, and nothing normative, to say about their patients. Nothing whatsoever. Putting a moral taint on schizophrenic behavior (i.e. "you oughtn't to do that") is none of their business. Trying to enforce norms of behavior is similarly none of their business, which means they have no right to call the police, and no right to manipulate, etc. etc. etc.
Take this example. A psychiatrist labels you with schizophrenia. This means, among other things, that you tend to believe things which differ radically from accepted cultural beliefs. So what does this mean? Well, normatively, and morally, it means absolutely nothing. It is a statement of fact, akin to, "You have a wart on your nose." It is not the business of the doctor who points out the wart on your nose to say, "You are ugly because you have a wart on your nose." Or, "You need to get that wart removed." The sole purpose of the doctor is simply to state the fact and give you options for dealing with that fact. Since a psychiatrist is a doctor, he has no right to say, "You need to take Olanzapine in order to stop having delusions." Nor does he have the right to try and manipulate you into taking medications by saying, for example, "You will continue to suffer these problems and alienate yourself until you take my prescriptions."
Nor does the psychiatrist have the right (and this is the most significant point) to say, "Your thoughts are delusions and are therefore wrong." This is an ideological, evaluative statement, not a statement of fact. It reflects a certain philosophical ideology of what constitutes objective reality. But that isn't the proper domain for the scientist qua scientist. The scientist qua scientist is supposed to say things like, "Your thoughts are delusions." But they aren't supposed to say, "Delusions are morally bad." Or even, "Delusions are objectively false." The moment he does such a thing, he is judging your worth as a human being, and stepping beyond the proper role of the doctor.
Doctors make observations, and classify observable aspects of your being. But such classification, although it may come with baggage, says absolutely nothing beyond this domain. There is no reason for someone to feel upset because her thoughts have been classified as "delusions." In fact, since delusions show a marked difference from common beliefs, which are often very morally questionable, delusions may even be valuable. Delusions may make a significant, positive contribution to the marketplace of ideas. The psychiatric labels, including schizophrenia or bipolar disorder, are exactly the same. Schizophrenia or bipolar, therefore, may be a positive thing, and not necessarily something to be eradicated or controlled. In any case, the project of eradication and control of schizophrenia or bipolar disorder is the project of you as a patient, not of the doctor. The doctor may help, but the doctor by no means is supposed to take control. Just because a doctor identifies a wart on your nose doesn't give him the right to eradicate it. That is your responsibility, and your choice.
