SHRINKING THE SHRINK

And while the numbers vary, it is conservatively estimated that on a yearly basis as many as 750,000 Canadians will consult a psychiatrist. Of the many more with mental health problems, 30% are sufficiently stigmatized by the social implications of requiring psychiatric treatment that they refuse to go; the remainder opt for alternative therapies. As far as I know, none of the above has sought the counsel of a philosopher, forcing the conclusion that troubled Canadians are either immune to philosophical problems or deem their problems not of a philosophical nature.

In light of the dark fact that the philosopher, to all intents and purposes, has been banished from public life, how is it that we, en masse, have come to view our mindaches as miseries that should be submitted to the care of psychiatry and not philosophy, and does this (mis)perception bear on the increasing number of Canadians undergoing psychoanalysis?

The discipline of philosophy is 2,500 years older than psychiatry, and yet the latter, in a mere century, has come to be seen as the exclusive arbiter of problems, many of which once belonged to philosophy proper. How did philosophy fall into such disrepute and desuetude, or, flipping the 24-carat gold coin, how do we account for psychiatry’s swift ascendancy? Could it be that when the latter was in its infancy, it had the presence of mind to align itself with science, whose pedigree and methodology promise answers and solutions to our seemingly intractable problems? If I’m trying to get from one day to the next, how can philosophy, which leisurely investigates the largest questions of life with a deliberate emphasis on the asking and refinement of the question, compete with psychiatry that offers in equal parts comfort and cure? Small wonder that philosophy came to be viewed as a waste of time and tender and fully deserving of its peripheralization. But even Freud revolted at the fact that a medical degree was a prerequisite for the study of psychiatry. “As long as I live I shall balk at having psychoanalysis swallowed by medicine.” He believed the study of the history of civilization and sociology were the most effective preparatory disciplines for psychiatry.

When, in The Gay Science, the philosopher Friedrich Nietzsche (1844-1900) pronounced “God is dead”, he could have just as easily noted the same for the once revered philosopher kings. Nietzsche, whom Freud (1856-1939) declared "had a more penetrating knowledge of himself than any other man who ever lived or was ever likely to live," begins On the Genealogy of Morals with this observation: “We are unknown to ourselves, we men of knowledge -- and with good reason. We have never sought ourselves -- how could it happen that we should ever find ourselves?” He then goes on to cite a law: “Each person is farthest from himself.”

With more and more Canadians on their backs coughing up big bucks on psychiatrists’ sofas, there is little evidence that the farness that troubled Nietzsche has been brought nearer, or that the mental health of the nation is on the improve. Canada’s per capita consumption of pills has doubled during the past two decades, with an ever-increasing percentage slotted for the mind. And while there is general concern that patients are becoming more and more reliant on the next generation of made-to-measure serenity drugs, there’s a disproportionate lack of concern that more and more psychiatrists are hooked on the prescription path of least resistance for illnesses that, based on outcomes, should be reclassified as analysis-resistant.

When it comes to the practical negotiation of our unhappiness, psychiatry and philosophy offer two diametrically opposed approaches. Nietzsche, in Thus Spoke Zarathustra, prescribes: “The Superman despises himself the most.” Which simply means if you like yourself as you are, you’ll remain as you are, which is the starting point for psychiatry that accepts you as you are with the endgame of getting you to like yourself as you are. So if you are depressed, let’s say, because you are chronically weight-challenged and unable to attract a romantic partner, the psychiatrist will endeavour to render you self-esteeming by emphasizing your other good qualities: generosity, loyalty, dependability, and then condition you to take control of your life, meaning no longer allow yourself to be held hostage by negative public perception. And at the end of the very expensive day, thanks to the psychiatrist’s munificence and methods, you will not have had to shed a single pound and the incurably judgmental world will now observe you waddling down the street all cheerios and smiles. Add to that the over supply of happy pills on the market to facilitate that happy result, and somewhere over the rainbow there’s a guy or girl and a box of low cal chocolates waiting just for you.

The philosopher, on the other hand, will make you stand in front of a double size mirror until you succumb to unbearable disgust and revulsion, all the while being made to understand that your obesity is not only inadmissible in and of itself, but is a crime against life, at which point, as a first effect of seeing yourself in the truth of your XXX-Large life style, you will perforce become so overwhelmed with self-loathing you won't even have to go on a diet but will drop weight as a consequence of what your understanding reveals as the proper course to follow in paying due honour to the gift of life. As a textbook illustration of substitution theory where a bad habit is replaced by a good one, your hunger for food will be replaced by a philosophical hunger that only self-examination can satisfy.

As it concerns the many who have worked hard and have satisfied all material wants but are inexplicably anxious or depressed, the psychiatrist will spend months, if not years, trawling the patient's forgotten childhood until a bona fide trauma or two are dredged up from the depths, but will not raise the question of what constitutes a meaningful life even though the sufferer has invested his or her entire existence on the self-evidently false presumption that satisfaction of material wants translates into happiness. Among the many existential sicknesses of being (absolute belief in materialism) the psychiatrist cannot shrink, this is surely one them, and is proof that, pace the ancients, the unexamined life is not worth living.

Regarding the unhappy short male who is rejected because of his height, no matter how artfully the psychiatrist delegitimizes the rejectoress – her shameless, bankrupt values which should, in theory, automatically disqualify her as potential mate – hocus pocus focusing on the positive will never offset the facts and effects of rejection. Nor will the patient be helped by hug therapy or being made to relive the slap he received from his mother when he peed his pants at the age of four. As philosopher Merleau-Ponty (1908-1961) says of the cripple, it is the price he pays for being in the world: life isn’t fair and the reasons for it count für nichts. The ugly person or cripple when reading a book is neither ugly nor crippled, but someone who is reading a book. Which is to say there is no getting around the truism that we are all inescapably what we do, which makes the number of hours we comparatively and statistically dwell in being short, crippled or ugly a choice for which we are responsible.

Since the average hourly fee of the psychiatrist ranges from $75 to $150/hour, the affluent disproportionately frequent psychiatrists: in particular women who don’t have to work, who have never had children or whose children are grown up, who are unable to fill in their time, who resort to alcohol and drugs to get them through the day, who suffer from chronic enervation and are living proof of the existence of zombies. By the time they bring themselves to a shrink, they are so shrunken in spirit they have become unrecognizable to their friends and even family members. And yet, from our earliest years, we are taught to admire and emulate these financially liberated women without ever questioning what it is that we are admiring that leave so many of them prone to prolonged unhappiness (depression). From the get-go, the philosopher will question the societal goal (myth) that encourages and rewards its members whose stated ambition it is to go from being socially useful to useless – a sure prescription for despair that targets especially the leisure class and retirees. Unlike sated beasts that are content to merely exist, Man requires a purpose in life and all the analysis of the mind’s deep won’t change that primordial desideratum.

Since it is in the productive interest of the nation to get the tens of thousands of Canadians presently on their backs back onto their feet, is it reasonable to expect Health Canada to productively intervene, or would we be wiser to place our hopes on a spontaneous, philosopher-led patients revolt? To expect the psychiatrist -- who has neither the training nor expertise to treat patients suffering from existential illnesses -- to possess the wherewithal and professional dignity to recommend his patients to the care of the philosopher is tantamount to expecting a dwarf to make do with shoes of a giant, a sure formula for comedy if it weren’t so tragic. Even more unrealistic is to expect Health Canada to designate its most basic assumptions on what constitutes a positive mental health outcome that which most deserves to be called into question.

In the indeterminate meantime but in the spirit of a new enlightenment that is slouching towards Bethlehem, I urge all philosopher kings in waiting to hang out their shingles and distribute their business cards: their second coming is assured by the growing number of misdiagnosed, mentally anguished Canadians who are a mere one good read away from realizing that they deserve much better than the costly, habit-forming, ineffective combination of palaver and pills routinely prescribed by the good psychiatrist.