Dr. Gordon Warme argues there's no biological basis for mental illness
Dr. Gordon Warme is 73, a distinguished psychiatrist who taught at the University of Toronto for three decades, and the proud new owner of a pionus parrot from South America, a genus known for its subtle coloration and relatively quiet voice. He's also a heretic -- a psychiatrist and psychoanalyst who maintains, in a polite and muted fashion, that there isn't a scrap of evidence that mental illnesses are caused by any biological dysfunction. Warme argues in Daggers of the Mind, a humane apologia for his profession, that science, and drug-obsessed psychiatrists, are charging down the wrong track, misleading patients and forgetting that "most, if not all, of the effects of psychiatry are magical."
"Psychiatrists committed to biological explanations," Warme says in an interview, "will show me brain scans and point out tiny abnormalities in a high percentage of the brains of schizophrenia patients -- but the same range of imperfections will show up in healthy people's brains. If I push them and say, 'Show me evidence,' they'll finally say 'You're right,' but they don't want to talk about it. If you want to get ahead in our profession you have to write papers that promote this nonsense. And that's morally wrong. To tell our patients -- without any evidence -- that they have abnormal brain chemistry is just as crazy as some guy over there shuffling, grunting and staring into space."
This is heresy indeed, in an era in which the biological roots of virtually every unhappiness is an article of faith among experts and lay people alike. The sharp point of Warme's spear is aimed straight at schizophrenia -- the mental disorder most adamantly portrayed as an organic disease by those who treat it, and by the families of those who suffer it. Any textbook, any website devoted to the condition, opens with a confident statement of fact -- Warme would call it superstition: schizophrenia is a brain disease. Only further in will the reader find what Warme points to as telltale signs of pseudo-science -- researchers "do not yet understand all of the factors," or "it appears likely that."
Warme argues that psychiatrists have forgotten that illness is a metaphor for what they are observing -- a very useful metaphor, Warme agrees. The disease concept "removes the urge to fear or hate, the judgmental element." But it adds a declaration of biological abnormality -- read biological inferiority, according to Warme, who considers the label an affront to the autonomy and human dignity of his patients.
What, then, does a skeptical and infinitely curious headshrinker, a mental health professional who tosses around words like "crazy" and "mad" in exactly the same way as regular folks do, make of schizophrenia and other mental disorders? It's worth bearing in mind that heresy, too, is only a metaphor, for Warme offers no counter-church with an absolute truth of its own. "Madness," he says slowly, "is another way of life, another way of being human. Schizophrenia is stable across time and place; its roots are archetypical -- every culture provides its members with a blueprint on how to be mad."
The suffering is real, and so is the help experts provide. But what psychiatrists actually do is not far removed from the rituals of a Mayan shaman waving a chicken over a troubled patient. Even drugs, which have a success rate barely distinguishable from that achieved by sugar pills, function entirely through the placebo effect, what Warme calls the enchantment or magic of his profession. "That's where I really get into trouble," he says, "when I say all psychotherapy is a placebo, when I tell my closest associates that for all the good we can do through wise talk and encouragement, we do not cure our patients, because they never had a disease."
What do his own patients think? "For 20 years I've seen people who came to me saying they were depressed. After 10 minutes they never say the word again, even if I see them for five years. It's clear to me that 'depression' is a magic entry phrase to one of the wise men." And unhappy people have even more practical reasons for claiming depression: "Does medicare pay for you to go to a doctor to say 'I'm not getting along with my husband'?" Warme asks sardonically.
Human suffering is eternal, Warme believes -- there will never be a biological, drug-based fine tuning that will end it. Warme has no objection to any relief that can be offered without serious side effects, from drugs to electroshock to sacrificed chickens. But as a rational humanist skeptic, what he really believes in is the aesthetic cure. "In films, books and operas, we discover human nature writ large, with complexities, blemishes and perversities included. Like psychiatrists, art invites you to wrestle with ghosts. I listen to my patients and they tell me the same archetypical stories I read in Homer." His job, Warme figures, is to convince patients to become more conscious creators of their own selves, "to look over the way they have lived their lives, to tell them that the story you have lived up to now -- you might benefit from a different story."
No comments:
Post a Comment