Though it permeates all life, consciousness seems somehow subjective, almost hypothetical. Yet human awareness is our connection to the world, and mind is our decision maker. The current trend in psychology and psychiatry is to view consciousness and behavior as byproducts of brain chemistry; to diagnose by lists of symptoms; and to treat mental, emotional, and behavioral problems with various drugs. Still, a significant number of therapists dispute the value of this approach for the majority of their patients, and present a variety of alternatives. The three approaches considered below revolve around the ability of ordinary people to take charge of their lives by examining themselves, making effective choices, and building healing relationships.
In Choice Theory: A New Psychology of Personal Freedom (1998) psychiatrist William Glasser encourages readers to abandon the psychology of external control and instead recognize that right now and inevitably they exercise internal control over their thoughts, behavior, and much of their feelings and physiology. Human misery, he feels, is rooted in the fact that trying to control others is the accepted strategy in almost every area of human life. Once people realize that everything they do, think, and feel represents choices they are making, they can choose to respond with thoughts and behaviors which will produce more positive results. The author challenges people to put good relationships at the center of their concern and, instead of trying to coerce or resist others, to evaluate their actions by asking: Will what I am about to do bring me closer to these people or move us further apart? Rather than blaming others and trying to change them, we can ask ourselves what we can give of ourselves to improve the relationship, and try to discover some of the things we are doing to weaken it. Such questions demand honest answers and lead to a genuinely frank appraisal of one's own attitude and behavior.
Dr. Glasser believes that focus on a patient's early experiences, rather than on those of the current individual, is misplaced and unproductive because we can only move ahead from where we are today by beginning to make better choices now, whatever the causes of our circumstances and personality. More disturbing to him is the routine use of chemical treatments. In his experience, problems with personal relationships cause most patients' symptoms, and generally their reactions are not caused by chemical imbalances in the brain but are the normal physiological response to the behavior and thoughts they have chosen to adopt. He feels that those experiencing a severe psychological crisis may require a prescribed drug, not as a chronic treatment but only until they regain the necessary balance to realize that they want to and can heal themselves. In his decades of practice, he himself has not needed to prescribe psychiatric drugs.
Another psychiatrist, Peter R. Breggin, has been at the forefront of protest against biochemical theories of psychiatry and the indiscriminate use of psychiatric drugs, particularly on children. His recent Reclaiming Our Children (2000) was sparked by the response of the U.S. government and the psychiatric and educational establishment to the Columbine High School shootings: screen more children for psychiatric disorders and treat more of them with drugs such as Ritalin and Prozac. Schools increasingly refer rambunctious or uncooperative students of all ages to doctors and psychiatrists in response to behavioral problems, many ending up diagnosed as mentally disturbed or as having brain abnormalities. Such a referral "almost guarantees that they will be treated with psychiatric drugs" (p. 82), many of which have not been tested on or approved for children. Moreover, their side effects have not been investigated or documented by their manufacturers, despite reported cases of permanent brain damage.
Dr. Breggin's alternative revolves around healing relationships and changing adult priorities and choices. Parents, teachers, caregivers, and citizens must take more responsibility rather than expecting children to conform to adult convenience and desires. Parenthood, he maintains, is a form of service where we must learn to be selfless but, as psychiatrist Doug Smith remarks, "We have absolved ourselves of the sacred responsibility to make sacrifices for our children. Instead of seeing the sacrifice as a holy trust and privilege, we see children as inconvenient nuisances" (p. 83). Instead of asking, What is wrong with my child?, we need to ask, How can I transform myself to meet my child's needs? Dr. Breggin recommends that "The first step is to take every child seriously. As a part of that, we can greet the essential goodness or even the divine spark that we meet in each child. Children will respond in startling and gratifying ways when we greet them as people to be treasured in our lives" (ibid.).
In this process he recommends talking intelligently with children, who are very perceptive, as Dr. Alfred Adler noted:
I have never known a child who could not understand his difficulties when they were set before him. If I find a child who fails to follow me as I trace the roots of his mistakes, I can always be sure that I have blundered either in interpreting his situation or in describing it to him. Every normal [that is, not feeble-minded] child is capable of fathoming the springs of his own actions and reaching a true understanding of his own life. — p. 86
Dr. Breggin compares the pharmaceutical treatment of many children today unfavorably with the response we would give to a traumatized refugee boy who is depressed and unwilling to speak, angry and frightened. He would be encouraged to tell his story while being given adult support in working out his problems. But many parents of a child with these same symptoms
who bring their child for help these days all too often believe that the child has no story to tell the psychiatrists. They have no explanation for their child's dejection and unwillingness to talk. The psychiatrist also often doesn't press for any details about the family's history and current functioning as it affects the child. Instead, the doctor diagnoses the child with "clinical depression" or some similar disorder, and prescribes drugs.
If the little boy. . . began to show a great deal of fear and anger, he might be given a second diagnosis, such as oppositional defiant disorder. Little or no effort would be made to discover the source of his anger and conflict with his family. Instead, he would be prescribed more drugs. If he continued to refuse to communicate, he might be diagnosed with autism or schizophrenia, and be given the most toxic agents of all, the adult antipsychotic drugs . . .
Instead of discovering the child's story, the biologically oriented psychiatrist might inform the little boy's parents that their son suffered from a brain disease or a biochemical imbalance. The doctor, exactly like the psychiatrists who spoke at the White House Conference on Mental Health, might become emphatic about it: Nothing in the boy's life could have caused his sadness and withdrawal. . . . Any attempts to talk with the child would focus on disclosing serious "symptoms," such as hearing voices or wanting to kill himself.
Doctors nowadays often assume that children have no story to tell, but like the refugee child encountered on the road, they often have tragic stories to tell — if only we would listen. Through our listening the children might find some relief, we would engage them in healing relationships, and we would discover better ways to help, . . . — p. 114
Still another approach is presented by Lou Marinoff, a philosophical practitioner, in Plato, Not Prozac! (2001). He hopes to reawaken modern people to the practical value of philosophy in solving life's problems. Unfortunately, most university courses in philosophy are geared to an intellectual elite and the subject is not presented as a guide to life, a solver of personal problems, and a pathway to greater understanding of the universe. Like the two preceding therapists, he criticizes many practices common today, such as focusing on the patient's past, diagnosing based on lists of symptoms, and treating many patients with drugs. As a therapist he has found that people's problems most often arise from personal relationships or factors such as ignorance about ethics or a lack of reflection. Examining their life and thinking seriously about philosophy very often allows them to solve their own difficulties.
In his therapy Dr. Marinoff recommends that people study philosophers responsive to their personality and situation, and his book discusses many schools and individuals, Occidental and Oriental, ancient and modern. People need to discover for themselves which philosophies meet their needs, and becoming acquainted with them takes effort — but the rewards are worth the time required. Those who come to him usually face problems centered on family conflicts, different ideas from a partner about the future, a determination to control or not be controlled, or dissatisfaction with a job, boss, or uncooperative workmates. He calls his program PEACE: P for the problem; E for how the problem affects the emotions; A for analysis, figuring out ways to solve the problem; C for contemplation, pondering which solution will be best; and E for equanimity, finally making the right decision. Dr. Marinoff doesn't make decisions, but listens, speaking of healing philosophy and stressing each individual's limitless power through self-reliance. Sometimes one visit proves enough; only one client needed to continue therapy with him for a year. His final words sum up his views:
How freely we live depends both on our political system and on our vigilance in defending its liberties. How long we live depends both on our genes and on the quality of our health care. How well we live — that is, how thoughtfully, how nobly, how virtuously, how joyously and lovingly — depends both on our philosophy and on the way we apply it to all else. The examined life is a better life, and it's within your reach. Try Plato, not Prozac! — p. 271
Our human consciousness and will suggest that our possibilities are far greater than we often believe. We need not see ourselves as victims whose moods and awareness are determined by our biochemistry. In the great majority of cases, if we choose to exercise self-control and examine our relationships and situations without blame, we can learn to direct our thoughts, behavior, and feelings, overcome old destructive responses, make new habits, and create happy and fulfilling relationships with those around us. In this way we contribute not only to our own welfare, but to the happiness and peace of others.
(From Sunrise magazine, April/May 2002; copyright © 2002 Theosophical University Press)
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