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Towards a Liberation

Dr. Michael Corry, (MB.Dch.DObs.MRCPsych.MMed.Sci.) 
of the institute of Psychosocial Medicine, 2, Eden Park, Summerhill, Sandycove, Co. Dublin, tel. 01 800084, talked 
about the future of psychiatry and psychotherapy to
 Mary Montaut.

The Shoehorn of Psychiatry

Although psychiatry started in analytical psychology, it has moved towards a much 
more medical interpretation and is inclined to see mental distress as an illness and 
treat it by various medical means, ranging from psychoactive medication through
 hospitalization to more invasive forms of therapy like ECT and, in England and 
America, psychosurgery. I think that psychiatry will go through its own form of 
perestroika and move towards less absolute ways of interpreting what is going on
 psychologically in people’s lives. But to be fair, I think psychiatry is caught in a 
difficult role where it services society as its psychic policeman. How can we as
 doctors, as psychiatrists, work when there is fear on one side of the relationship and 
power on the other? People are genuinely afraid to come near a psychiatrist because 
they know something may happen to them beyond their control. I think psychiatrists 
have to make up their minds about whom they are serving – are they serving society? 
Or their clients? Or indeed are they serving themselves? Can they truly be at one
 with themselves doing this job which sometimes involves taking away the personal 
liberty of an individual through involuntary detention, and doing so outside of a court 
of law? This makes psychiatry the most powerful body in the land – no other
 profession can detain people outside the law and against their will.

Furthermore, I wonder if we are dealing with illness at all in the first place? The
 reason why a person can be detained under the mental treatment Act is to receive 
treatment on the basis of illness, but we know that years and years of hospital
 treatment may not change the phenomenon. Either we are working with an illness 
like pneumonia or diabetes, with a similar timespan and phenomenology; or else we
 are dealing with something we may call an illness but which is in fact an existential 
problem and a statement about the angst of human beings interfacing with the
 difficulties which surround them. You can’t have it both ways. To reframe those 
difficulties as illness is, to me, a real travesty. It reduces people, it minimises people 
and in fact it is holding back social change and social reform. As psychiatrists, it is as
 if we are on the sidelines of a game: we treat the injured as they come off the field but
 we are not allowed to have any say in the rules. I believe that doctors and psychiatrists
 have to make up their minds whether they want to be casualty officers to a society 
which is breaking down, or whether they see their role more in terms of the body 

The Need for a Contemporary Morality

In medicine we seem to have forgotten the context in which the human organism 
is living and we are always treating it without looking at the environment which may 
be causing the stress. I would hope that there will be a movement in medicine
 towards the community, lifestyle, stress management and that it will become much 
more holistic and ecological. I should like to see psychiatry move back to a more 
psychotherapeutic approach, where a human being can only be understood in the
 context of a milieu. All of us are the products of the interfacements we have had in 
our lives. We have actually had very little choice. No-one consulted us as to what sex,
 nationality or colour we wanted to be. We pay lip service to a lot of values but in fact 
human beings do not have much choice. I think that freedom begins when they
 finally realise that. We are truly conditioned if we don’t realise how conditioned we
 are. Most of us work the world from beliefs and value systems that have nothing to do
 with our own existences. We need a contemporary morality based on individual
 existentialism. We need to say, “Well, if I have had very little choice and most of the
 important decisions have been out of my control, paradoxically I am perfect. The way 
I am at this moment is the only way I could be. I can evolve from that starting point”.

Undoubtedly a human being is divided between a part that observes and a part 
that performs. In a sense, a human being is an actor born onto the stage with no say 
as to where or when, handed a script and told he’s on. It is very sad that the observer
 part of us, the witness, who really should be in the front row applauding us, has been 
called to the back of the hall, got at by various institutions as to how we should act, 
then goes back to his place and starts abusing us. Most of what I see in my work is 
people who do not like themselves, who hate themselves, who do not love themselves.
 We are the only form of life that can look at itself. It is tragic that, in using this gift of
 evolution, we are actually undermining ourselves, undermining the millions of years 
of knowledge – because of ideas. Ideas are only there to complement the witness, to
 complement creation. It is very sad to meet people who are oppressed by ideas 
because they never had a chance in their lives to evolve ideas which are
 commensurate with their feelings or to gain a sense of the direction in which they 
particularly wanted to go. Rather than the notion of Descartes, Cogito ergo sum (I 
think therefore I am), I think it is much more appropriate to say I feel therefore I am.

It is the feeling of  “what it is like to be me” that gives us individuality, the sense of
 personhood. Like a nation, we have our own boundary, the right to import and
 export, to fly our own flag. On the surface that may be labelled as selfishness, but in
 fact the moment you develop a self that loves itself and negotiates across its boundary
 with the world, you are likelier to treat others with the same respect. It is auto-poesis
- self-making – in the context of others. So to me, psychotherapy is about personal 
liberation and growth.

The Wisdom of Evolution

I suppose that psychology has to be seen in the context of what is called unconscious knowledge or innate knowledge: the wisdom of evolution.
 Metaphorically we could see self-consciousness as a stream of consciousness full of
 thousands of thoughts, values and beliefs, flowing past a window of perception. The 
fact that those thoughts, values and beliefs are in the stream does not mean that they 
are ours. Most of them have been put there by various agencies. It is like a river with 
a lot of pollution in it – which we may decide to throw out. We are inclined to spend
 time on negative thoughts as if somehow they are ours, but you can’t make a negative
 positive. It would be as if the river said it could turn a beer can into a lotus flower. 
Ultimately we have to let go of those thoughts and to choose the direction we want to 
go. The road back to wholeness is through loving ourselves. The whole of society 
seems to be against that; if we loved ourselves, we would not consume at the rate we 
do consume things, we would discriminate, we would be selective. The oneness 
between the witness side of us and the actor side is quickly undone from the
 beginning. There is a whole language dealing with a child who loves himself – we say “W
ho does he think he is? He is too big for his boots, cut him down to size, children
 should be seen and not heard.” In therapy if we could develop a language and style
 whereby we can help people to give themselves permission to be the way they are, we 
can help them to love themselves and to manage the boundary around that love. I 
believe that oneness in spiritual terms is the coming together of the observer with the
 actor. The person needs to have a boundary to give them the confidence not to be
 anxious and watchful, and which can let things in and out. Somehow we have got to
 have a mission which is about being auto-poetic – looking after oneself. When I was
 in Africa I could see that our nearest relatives really do this – most of the time they
 eat well, they sleep well, they groom each other. They really do love each other and 
look after each other. Obviously within man too there is the information to be co-
operative, to be gentle and to accept each other. We must personally learn to get in touch with the life-force, with our own inner voice, and learn, how to dovetail our
 thinking with a personal vision/mission that develops oneness with self, others and the environment.

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