PSYCHIATRY IN CRISIS: PARADIGMS AND INTERVENTIONS

A given paradigm determines the observational methods and treatments of the patients. Basic to medicine in all cultures, including ours, is the assumption that people who do not function in a given society are ill; they are not in order and require change. Thus, if we assume that people are sick, we shall find its cause and eradicate it. Our observations focus upon the symptoms which correspond to our definition of a given illness. Curing a patient means, then, eradicating his symptoms so that he corresponds to our definition of normalcy.
My conclusion from supervising psychiatrists and psychologists working with psychotic patients is that when the above paradigm does not produce the desired results, the reason for failure is not always due to a given therapist’s inability to apply the medical model. A core difficulty in dealing with psychotic states is frequently traceable to insufficient training in observing the actual details of the patient’s behavior. Thus, the detailed behavior of the individual patient is frequently glossed over. For example, a patient who is very passive and involved in his treatment is obviously going to be more responsive to medication than another patient who considers herself a revolutionary and finds it necessary to despise authority. In the process paradigm, to be presented briefly in the next chapter, the client is not considered, a priori, to be sick. We do not assume that his brain is functioning improperly, or that he is conscious or unconscious. Rather, the exact nature and content of his utterances and body signals are studied with the idea in mind that appreciating these details will help him best. We assume that if the signals and goals of altered and normal states are followed, life is going to be more worthwhile to him afterwards than if we only attempted to get him back on his feet and function again.
*2\227\8*

Share and Enjoy: