There is not much science involved in psychiatry. Mental illness can’t even be defined, much less cured. People who commit irrational acts are often declared to be mentally ill – in retrospect. However we all sometimes commit irrational acts. I’d be suspicious of anyone who claimed they didn’t. Nevertheless no specific irrational thought has ever been associated with a specific mental illness. Science has discovered that damaged brains can produce irrational thoughts and behavior, but no physical defect has been found for most of what psychiatry labels mental illness. Freud was among the first to try to talk people out of their illness. Lack of success for this “treatment” must have been frustrating. Finally psychiatry persuaded the public that everyone is somewhat mentally ill. Neurotic is the term they chose. Then they invited patients to lie around on couches, discussing dreams and exotic thoughts – especially rehashing long-forgotten conflicts with Mother. Some neurotics enthusiastically cooperated, thoroughly enjoying the experience. Some were even convinced that they had been cured of something. It was certainly more satisfying for the therapist than treating real psychosis, something for which there is still very few treatments or cures.
I recently read As Nature Made Him, by John Colapinto. It tells of two Canadian boys, identical twins. The penis of one was accidentally destroyed during circumcision. Dr. Money, a psychologist at John Hopkins in the United States, was promoting a theory that sex is determined by nurture rather than nature, and he persuaded the parents of the twins to administer hormones to the damaged boy, and raise him as a girl. Neither twin was told of the disastrous circumcision. Both boys were troubled during their childhood, and both made suicide attempts. The parents also suffered. The undamaged twin lived a conventional life, but the twin with the destroyed penis spent his childhood fighting to remain a male, and when he grew old enough to rebel, he refused to have anything more to do with the psychologist at John Hopkins. Nevertheless, Dr. Money wrote several books reporting the success of his “experiment”. Finally, when the twins were fourteen, they were told about the accident. The twin with the damaged penis was relieved to learn he had been correct all along in his insistence that he was a male. He underwent surgery, more hormone treatments to correct the estrogen he had received, and married a woman with three children. This twin became personally active in the controversy over attempts to change the sex of children. Nothing enhances life more than passionate participation in a controversy, and it has been my experience that protesting against a psychological theory can be even more emotionally satisfying than promoting one. The twin with the damaged penis apparently didn’t find his protest against psychology sufficiently rewarding; he eventually committed suicide. However some people actually find conflict a rewarding experience. I’m convinced it can strengthen, as well as damage us.
My own encounter with psychology occurred when my three-year-old son was diagnosed autistic. At that time Bruno Bettelheim, a psychologist at the University of Chicago, was promoting a theory that autism was caused by “maternal rejection”, and psychotherapy for mother was the treatment. I also suspect we were unknowingly involved in a "scientific study". During the early 20th Century, the height of scientific materialism, just about anything scientists wanted to do was considered ethical - after all, they were the priests of our modern religion, and whatever they did was supposedly for the good of mankind. In 1961, Kennedy, with a mentally disabled sister (who had been scientifically lobotomized), was our new President, and money was available for research on defective children. A generation of enthusiastic, young therapists had just completed training and were eager to display their wondrous, modern, scientific power to cure. Some therapists were bullies, convinced that their scientific truths justified coercion. However even the most benign therapists faced a problem. Most of them were men in those days (as were most doctors), and some of those nice young men were reluctant to be explicit. Maternal rejection is a pretty offensive concept, and how could they convince women it was nothing more serious than a mild, easily cured infection? How could they slip Mother a dose of psychotherapy without explaining exactly what they were doing? Awful as the experience was, I often managed to see humor in it. And hopefully the medical establishment has learned to view psychologists promoting theories with more caution.
The science I encountered during our psychiatric treatment was silly and easily challenged. The notion that psychotherapy for mother might be a treatment for defective children was abandoned. Challenging science can be a heady experience. Having once enjoyed the pleasures of skepticism, I seemed unable to control mine, until eventually I found myself questioning some of science's most basic claims. For instance science claims that the universe consists of nothing but matter and predictable physical forces. Reality seemed to me to consist of “something more”. Is creativity related to consciousness? Was it always a basic aspect of reality? Today many scientists acknowledge that living matter appears to have an ability to organize itself into purposeful, complex biological systems. Some scientists claim science is unable to deal with the concept of free-will and creativity. So if purposeful creativity actually is an aspect of reality, would that mean modern science would be unable to deal with reality?
People also differ over belief in the existence of progress. Some people insist that the human race is deteriorating, rather than progressing. They are probably the same people who feel damaged by traumatic experiences. Certainly the world is rife with challenges, and if one believed them to be damaging, it would be logical to conclude that the human race is deteriorating. Still most people assume the universe consists of the progression of an ever-increasing complexity. We are each of us one of Nature’s unique, but imperfect creations. Perhaps some of those deviations from average, sometimes regarded as mental illness - especially children with savant abilities which appear to be on the increase - are merely nature's tentative, incomplete, experimental attempts to organize new evolutionary adaptations to a rapidly changing environment. A relationship between mental illness and creativity is often argued, both supposedly occurring in the same families. Innovation might not be compatible with extreme stability. Whatever autism turns out to be, it is surely not an illness. It seems to involve the basic organization of the human organism, delaying development, and resulting in a decline of some intuitive abilities, such as language. As human self-consciousness has increased, should we be surprised to find ourselves depending more upon an ever-developing free-will, and less upon intuition? (Surely everyone agrees that we make more choices than are available to simpler organisms.) I am a religious agnostic. I don’t believe in a personal god. However I believe that life consists of something more than a mechanical device that only changes by accident. The notion that life develops purposefully is usually regarded as a religious belief, not a scientific concept, and science will never prove any religion, including the religion of Atheistic Materialism. Some of us prefer to keep our religious beliefs compatible with our science, and surely scientific evidence will be found that is compatible with (but not proof of) DNA changing in purposeful response to environmental pressures – by scientists motivated to looking for it.
I am proud to report that I survived the encounter portrayed here. Some of the therapists may have later searched for easier ways to earn a living.
A perfect universe would have no reason to evolve, and I prefer to think of myself as an active participant in an imperfectly created universe, rather than an impotent observer of an indifferent, mechanical reality. Thus, my thoughts and actions matter, as I strive to change and adapt - and make my small contribution to the growth of this great responsive, living existence. And if my contributions seem limited, they are enormous when compared to what I might enjoy under the concept of genetic determinism.
Revised as of November, 2014
This story is true. The names of the professionals have been changed to protect the guilty (but well-intended). There are no correct answers to most of the questions. Answers proposed by professional philosophers to such religious and philosophical concepts would be no more scientific than anyone else's speculations. Don't buy the book; it is obsolete. The newest version is all available here. Just follow the questions.
A Few Autistic Questions
About Freud, Marx and Darwin
Is any segment of society immune from silly ideas?
"Tell me about yourself," suggested the young pediatrician.
What a strange thing for a pediatrician to request! Especially a pediatrician at a busy Army clinic, where no one had time for idle social-chatter. Wearing a starched white coat over his Army uniform, the doctor sat behind his desk regarding me gravely through horn-rimmed glasses. I stared back, baffled. What did he expect me to respond? That I was an Army wife? But that was obvious, wasn’t it, since this was an Army hospital? It sounded like something a psychiatrist might say, not a pediatrician. I had never even met a mentally ill person; they were confined to institutions in those days. So I had only vague ideas about psychiatry. But while uncertain about what psychiatrists actually did, I was pretty sure I had no need for one. The silence became uncomfortable. The partitions of the clinic were flimsy, and I could hear a buzz of activity out in the crowded waiting room.
In those days we didn't consult a doctor for colds and minor problems. I often felt the obligation to convince doctors (and maybe myself) that my medical problem was sufficiently grave, but on this particular occasion no one was sick, and I hadn't arrived at the pediatrician's office in my usual state of anxiety. I did feel a little self-conscious about my reason for consulting a doctor. I'd brought Tony to the clinic, not because I thought something was wrong with him. My handsome, independent little three-year-old was actually in excellent health. I was here because a neighbor had suggested it. I would have felt foolish admitting I'd consulted a doctor just because a neighbor disapproved of my child, so I explained Tony didn't talk much, was still in diapers, and maybe he should have a check-up. But to my bewilderment, instead of examining Tony, the doctor kept trying to initiate personal conversation.
“How do you like the new administration in Washington?” he asked.
“It's exciting, isn't it?”
“Society will be in trouble unless people start taking responsibility for their own lives,” the doctor said disapprovingly. “People expect the government to do everything for them.”
I was a political liberal, who believed some of mankind's most magnificent accomplishments were achieved democratically, through government action. The abolition of slavery and the end of segregation were bitterly contested at the time, but most of us are proud of such achievements today. Establishment of an education system and Social Security were less controversial, but nostalgia for a more simple, primitive society always seems to ensure that all innovation faces some opposition. So I admired Kennedy, our new, liberal, young president, but I also realized some conservatives appear to feel a near religious reverence for "private-enterprise" and believe government should never interfere with the survival-of-the-fittest. (And the eradication of the less fit, I presume.) Apparently this doctor and I would disagree on politics, I decided, but a doctor's office didn't seem an appropriate place for such a discussion. I sat silently waiting for him to begin examining Tony.
“So now, why don’t you tell me about yourself,” the doctor again suggested, with a self-conscious little smile. He spoke rather tentatively, as though he realized his request was somewhat unusual for a pediatrician. I had never encountered a doctor with such a desire for social chatter!
I looked at Tony, busy examining the contents of the wastebasket. "Tony sometimes has a rather violent temper," I finally managed to offer, hoping to return the doctor's attention to his patient. Maybe one of Tony's glands needed adjusting or something. (My understanding of biology was obviously limited.)
“Does he understand what you say to him?” the doctor asked
“I'm never sure. He rarely does what I tell him but he's independent and stubborn.”
Tony was on his knees, his little blue-jean-clad rear-end up in the air and his head on the floor, trying to see under a partition into the next office. If anyone were on the other side of that partition, they'd probably feel uncomfortable to see his bright, inquisitive little face peering up at them. I picked him up and held him on my lap.
“How does he get along with other children?”
I thought a moment. “I don't think I've noticed him play with other children.”
“Does he have opportunities to be around them?”
“Off and on, I suppose. Actually, he doesn't play with his brother and sister very much.” I admitted.
“Where do you live?”
“In a big old house on a hill behind San Rafael.”
“You own your home?” I nodded. “You are lucky to own property in such a valuable area,” he continued.
He seemed to expect a response, so I tried to think of one. “The house is a hundred years old and has termites,” I said. “In the coming depression it probably won't be worth what we paid for it.”
“We don't have depressions anymore,” the doctor scoffed. Many of us who grew up during the thirties, sometimes accused of having depression mentalities, didn't really trust prosperity, but the doctor's comment seemed condescending.
“You are probably too young to know what a depression is,” I said.
The doctor frowned. I was startled by my own impertinence. I didn’t usually come out with such retorts. Suffering from shyness, I was rarely rude or impudent. Perhaps the doctor was just making an effort to be friendly. Army doctors were not known for their bedside manner though, and I'd never encountered one with time or inclination for this kind of personal conversation.
"Tell me about your husband," he suggested, ignoring my comment.
Tony slid off my lap to examine the scales. Again, I was baffled. I couldn't imagine why our personal lives might be of concern to this pediatrician. Surely he wasn't interested in Ike's vital statistics, such as height, weight or eye-color.
“He's stationed in Greenland at the moment,” I finally offered.
“Uh-oh! That's bad.” It seemed another strange reaction for an Army doctor. There was nothing unusual about overseas duty for military families. Again, I couldn't think of a response, and the doctor continued. “How do you feel about your husband's absence?”
"Well he'll be home in a couple of months."
The doctor glanced at Tony. After trying to turn the valves under the sink, Tony had crawled onto a bookcase. With a self-satisfied smile, he crouched on the bottom shelf like a life-sized bookend. We talked some more, and the doctor continued to try to discuss everything except Tony.
"Ever since you came your little boy has been running around the office examining the equipment," he finally said, as he watched Tony leave the bookcase and crawl under the desk. "He's paid no attention to me. Why he's hardly aware I'm in the room!"
Why should Tony pay attention to you, I wondered. You haven't done anything but talk, and Tony doesn't understand much of that. It was true that I was deciding the doctor was a little weird, but Tony wouldn't understand enough of our conversation to share my bewilderment. However I wasn't accustomed to challenging doctors, and I nodded.
"Your child is not normal," the doctor said.
"You really think so?" I murmered.
His words seemed to have no impact upon me. After all, he hadn't paid much attention to Tony. He hadn't even examined him! For some strange reason, that pediatrician acted as though his purpose was to indulge in personal conversation with me, Tony's mother. I listened to the doctor make another appointment for us, but I was busy puzzling over what on earth this peculiar doctor had been up to for the past half-hour. Ask a silly question and you get a silly answer, I thought as I left the doctor's office. Whatever that pediatrician had been up to, that's what I got for taking my child to a doctor when there was nothing wrong with him, I mused with chagrin.
I always dreaded talking to doctors. Like many people, I felt intimidated by the medical profession. Perhaps some doctors have become accustomed to such an attitude, and expect patients to exhibit proper respect for their authority, maybe with the assumption that such diffidence is an aspect of the healing process. And it probably is. I suppose faith in the infallibility of the medical profession could have a powerful placebo effect. It would never have occurred to me to challenge his pronouncement that Tony was not normal. Every child is a unique personality, but I'd never noticed anything about Tony's personality that struck me as abnormal. He obviously had more imagination than most children. And his curiosity was monumental. He was slow to mature, but my other son had also been a “late bloomer”. For some reason I viewed that doctor's pronouncement as bizarre rather than alarming. The pediatrician's attempts at personal conversation seemed to suggest a psychiatric interest. Psychiatric evaluations not being a pediatrician's specialty, the doctor's manner may have been a little clumsy. But whatever a psyche consisted of, I was confident there was nothing wrong with mine. Many of us had only a vague understanding of psychiatry, this new technology for repairing malfunctioning psyches. Today some scientists are pondering the complex nature of consciousness, but even without defining it, the psychiatric profession had already divided human consciousness up into imaginary ids, egos and superegos, and declared their ability to repair them. If we laymen didn't understand the details - well we also didn't understand lots of modern technology, such as the atom bomb, or how penicillin worked. My ignorance of psychiatry would soon be remedied, as our family underwent treatment. I had never heard of autism. Nor was I aware that Bruno Bettelheim, a psychologist at the University of Chicago, had convinced the medical profession it was a mental illness caused by "maternal rejection". Treatment consisted of a therapist (generally men) conducting an investigation into why mother was rejecting her child. The theory being, that once she understood the reason (usually some convoluted, psychoanalytic tale about a traumatic childhood of her own), mother would cease to reject and become a loving parent.
After losing my awe of medical science, one of the first scientific "truths" that aroused my skepticism was Neo-Darwinism, the belief that biological innovations result from "natural selection" doing something to a collection of genetic accidents. We don’t yet understand all the details of life's complexity, but what science has been able to learn about the process fills many, many volumes. Can anyone imagine a new biological feature appearing in one of those books as the result of a series of typographical errors - random mutations? Survival-of-the-fittest had been eagerly accepted by 19th Century scientists, probably because scientists of that time were struggling against a rigid religious orthodoxy. A hundred and fifty years later, a rigid materialistic orthodoxy had replaced religion for many scientists. Random-mutation-and-natural-selection is the only strictly mechanical explanation anyone had been able to devise for biological innovation, the only explanation for the origin of biological complexity that excludes any hint of intelligent, purposeful organization. Anyone expressing skepticism of the creative power of "natural selection" was scornfully denounced as an "ignorant religious creationist". However one does not even have to be religious to view volition and intelligent organization as natural aspects of reality. The truth is, any form of purposeful organization suggests intelligent design, but such purposeful organization need not be "supernatural". Certainly, there is nothing supernatural about our own purposeful, conscious, human creativity. Whatever the organizing force in living systems is labeled, biocentrism, self-organization, epigenetics, intelligent design, James A Shapiro’s genetic engineering - or a phrase that encompasses them all - cognitive biology, they are all closer to Lamarck's inheritance of acquired characteristics than to Darwin's RM&NS. The participation of some deity in the process can be neither confirmed nor denied. Evangelical atheists will eventually have to learn to live with the unwelcome possibility that no religion, no view about the ultimate nature of reality, can be either scientifically proved or disproved - and that includes the religion of Atheistic Materialism. Lamarck would be a more reasonable “father of evolution” than Darwin.