05 Nov

If thy ‘ead offend thee, cut it off

The country is terribly short of shrinks.

One in ten consultant psychiatrist posts in England are currently unfilled in the NHS,according to a report by the Royal College of Psychiatrists (RCP) and the number of unfilled posts has doubled in the past four years.

Wales is also struggling to fill posts, with vacancies of 9%, while Scotland and Northern Ireland have vacancy rates of 6% and 2% respectively.

The college called the vacancies “frankly alarming”  Prof Wendy Burn of the RCP, said the shortage means patients might be waiting months to see a psychiatrist, during which time they could be getting worse.

Professor Burn did not consider the distinct possibility that sufferers might get worse if they did see a psychiatrist. If you want to be a plumber, it helps if you’re a practical sort. Priests need to be religious. By the same token, many psychiatrists are more than a little mad.

I read the snooker champion Ronnie O’ Sullivan’s account of how, some years ago, he turned to a Freudian psychiatrist to help him overcome his depressions. Ronnie’s father was doing time for murdering Charlie Kray’s driver. The psychiatrist, having noted that Ronnie sometimes cued left-handed, asked him if his father had stabbed his victim with his left hand.  Ronnie’s comment on the psychiatrist’s question was: “It did me ‘ead in.”

There is a century old tradition of Freudian – or, as we say in English, Fraudian – psychiatry. And then between the wars there arose a fashion for Behaviourism. This is a science of the mind which does not think there is such a thing as a mind. So psychiatrists should study our behaviour which is defined exclusively in terms of stimulus and response – the famous S-R relation which the renowned Behaviourist B.F. Skinner (1904-1990) employed to teach rats the way out of mazes and pigeons to play table tennis.

(By the way, the “B.F.” stands for Burrhus Frederic – and not what you were thinking).

On this subject, Arthur Koestler commented: “Now that we have lost our souls, gone out of our minds and seem about to lose all consciousness, what is there left for psychologists to study? Professor Skinner’s answer is ‘Rats!’”

Similarly, the philosopher Peter Geach said, mockingly, “A Behaviourist knows he’s hungry when he observes himself running home for his lunch.” 

From phenobarbitone  – which I once heard mispronounced as “female baritone” – to Prozac, psychiatry has come up with a succession of wonder drugs. We were assured back in the 1960s that the new benzodiazepams such as Librium, Ativan and Valium – “mother’s little helpers” – so you see, it was the women who got to swallow the lion’s share – were without side effects and non-addictive. We now know that millions worldwide have been on these drugs for generations and can’t kick the habit. 

Scientific psychiatry brought forth many blessings. There was electroconvulsive therapy (ECT) – very popular in the 1950s and 1960s – which works by giving patients electric shocks to produce seizures which, it was hoped, might relieve the conditions of depression and mania. The treatment was typically administered to a patient three times a week for several weeks, very commonly to pregnant women and those going through the menopause. 71% of all patients treated with ECT are women. It is still being administered in NHS hospitals. Rosemary, sister to JFK, received this treatment and was incapacitated for the rest of her life. The distinguished New Zealand novelist Janet Frame was among countless others who suffered greatly owing to this procedure.

I suppose the mother and father of all treatments for mental disturbances is the frontal lobe lobotomy, named from two Greek words meaning “brain” and “slice.” The ultimate method, as Ronnie might say, of doin’ yer ‘ead in. Surgeons cut out part of the cortex. Again this is more often performed on women. Its inventor Antonio Muniz was awarded the Nobel Prize in 1949 for coming up with this little beauty. There is a vigorous campaign to have his award annulled.

Jesus famously quipped, “if thy hand offend thee, cut it off. If thine eye offend thee, pluck it out.” – Mark 9:43ff. The lobotomists have gone one better than the Lord: “If thy head offend thee, cut it off.” 

You know, I’m only an uninstructed layman in these matters, but I just wonder if, rather than seek ever more ingenious ways to treat mentally deranged people, it might be better to try to create a saner world? 

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