This is a small masterpiece, and so is the one about the horse, which I totally missed. I've been thinking (and writing a bit) about the DSM. How neat and tidy it is, the way people embrace their diagnosis, and what's missing. My schizophrenic brother grew up way before all this, he was from another world. His illusions/delusions were full of magic and poetry, art and philosophy, and he went down hard in life, died a terrible lonely death, ranting and raving about his visions and "the truth" which continues to feels more and more true. btw he also talked to cats, and about their x-ray vision (the cat rays, like your professor). I'm just sayin' who's to say what's crazy and what's genius, right? He would have loved your piece about the horse, I almost cried thinking about it.
Goodness, I am lost for words - so kind of you to say, Andrea. It is such a heartfelt comment. I am so so sorry to hear about your brother and the misfortunes he had to deal with throughout his life. I am now doubly lost for words. All I've got is thank you for sharing the story of your brother.
Don't misunderstand. His tragedy was the reason I turned to writing, painting and other art forms. It's the strange beauty of my brother's world and the story I've been trying to write, which is mostly a fictionalized account of his fantasies. In this sense his mental illness was a gift. It also sensitized me, like a radar, to other people's capacity for cruelty (bullying). On the flip side there's a radar for kindness and humor (absurdity). Your post and others on this topic serve as motivation.
This is a deep vein - we have slavishly followed the biomedical model into the halls of Mordant Empiricism and misplaced Joy. In my experience I would argue that diagnosis matters but more in the way of communicating in shorthand with other treaters than in actually treating patients. Each one of us is a horse in space …
Thanks for the mirth. Coming back to earth, this kind of diagnosis is LABELING and who wants to be labeled, put in a category. At least as it pertains to psychotherapy, is not what helps. Rather what does help is appreciating the unique situation of each individual.
How are you? I am so glad my article brought a little bit of joy to your life. Thank you very much for a comment which prompted a lot of thought on my end.
I can empathise and have been in many personal situations in the psychiatric system where I wasn't listened to and put into boxes.
Saying that, perhaps, if I may, bring us down to a more literal earth? If we wanted to describe, say, a city with the highest degree of complexity and accuracy, all we would end up with is an exact replica of said city – which would be useless to us. So instead we developed maps. Ways to represent the landscape to help guide us through our environment. And depending on our purpose, we use different types/scales/complexities of maps. More complex isn't always better. There is always a balance. Early London tube (subway) maps were more geographically accurate but terribly difficult to use. Modern maps use a more simplistic geometric design to aid people in understanding where they need to get off and on - each stop with a label.
I would argue the very words we use are a bunch of labels. Representations of things in the world and within us, linguistic maps. Often the most simple linguistic labels convey the greatest amount of meaning. "I", one simple letter, represents all of our personal human complexity. Should we ban the use of "I" in psychotherapeutic practice because of the inherent simplicity of the label? I would imagine some of the most meaningful deep expressions and understandings contain "I" in them. "I love you" a prominent (and simple) example.
This is why I find diagnosis conversation uninteresting. I think we are focusing on the labels themselves, rather than building maps from those labels.
Goodness, how much could psychotherapists learn from cartographers? Or from linguists? Learn ways to better help their clients express themselves and understand themselves?
Wow! Thank you Alex. Your response leads to important things. For me, the gold standard in describing the uniqueness of another human is ACCURATE EMPATHY. I define it as "an ever deepening, emotionally engaged understanding of the other's experience." It is not labeling because it makes use of the inner, type 1, nonconscious, survival-oriented, subcortical mind's native mode of association, metaphor, and imagery to gather and store information. In the same way, you mention "I" as an adequate descriptor for the uniqueness of a person because it makes use of that same associative mode of thought and yet admits that it is still inadequate in describing a person. I think appreciating this is one of the important things we all need to understand. Just as a picture is worth 1000 words, metaphorical truth is often more true than dry, logical truth. Jeffery
This made me think about how often breakthroughs come from borrowing ideas outside our own field instead of polishing the same debates. Some of the best questions sound a little ridiculous at first, right up until they lead somewhere nobody was expecting. That's usually where the interesting work starts.
This is a small masterpiece, and so is the one about the horse, which I totally missed. I've been thinking (and writing a bit) about the DSM. How neat and tidy it is, the way people embrace their diagnosis, and what's missing. My schizophrenic brother grew up way before all this, he was from another world. His illusions/delusions were full of magic and poetry, art and philosophy, and he went down hard in life, died a terrible lonely death, ranting and raving about his visions and "the truth" which continues to feels more and more true. btw he also talked to cats, and about their x-ray vision (the cat rays, like your professor). I'm just sayin' who's to say what's crazy and what's genius, right? He would have loved your piece about the horse, I almost cried thinking about it.
Goodness, I am lost for words - so kind of you to say, Andrea. It is such a heartfelt comment. I am so so sorry to hear about your brother and the misfortunes he had to deal with throughout his life. I am now doubly lost for words. All I've got is thank you for sharing the story of your brother.
Don't misunderstand. His tragedy was the reason I turned to writing, painting and other art forms. It's the strange beauty of my brother's world and the story I've been trying to write, which is mostly a fictionalized account of his fantasies. In this sense his mental illness was a gift. It also sensitized me, like a radar, to other people's capacity for cruelty (bullying). On the flip side there's a radar for kindness and humor (absurdity). Your post and others on this topic serve as motivation.
This is a deep vein - we have slavishly followed the biomedical model into the halls of Mordant Empiricism and misplaced Joy. In my experience I would argue that diagnosis matters but more in the way of communicating in shorthand with other treaters than in actually treating patients. Each one of us is a horse in space …
I love this!
You made your point, but you still owe your readers a brief outline of what putting a horse in space would involve 🙂
Thanks Adina, so glad you loved it! Fortunately, my debt is prepaid 😊:
https://psychiatricmultiverse.substack.com/p/what-if-a-horse-was-mistakenly-sent
“Why do I feel like I am going to be the one who writes this article?” I was hoping you would! If you want to collaborate, hit me up!
Definitely up for a collaboration! Will send you a DM 😄
Thanks for the mirth. Coming back to earth, this kind of diagnosis is LABELING and who wants to be labeled, put in a category. At least as it pertains to psychotherapy, is not what helps. Rather what does help is appreciating the unique situation of each individual.
Hi Jeffery,
How are you? I am so glad my article brought a little bit of joy to your life. Thank you very much for a comment which prompted a lot of thought on my end.
I can empathise and have been in many personal situations in the psychiatric system where I wasn't listened to and put into boxes.
Saying that, perhaps, if I may, bring us down to a more literal earth? If we wanted to describe, say, a city with the highest degree of complexity and accuracy, all we would end up with is an exact replica of said city – which would be useless to us. So instead we developed maps. Ways to represent the landscape to help guide us through our environment. And depending on our purpose, we use different types/scales/complexities of maps. More complex isn't always better. There is always a balance. Early London tube (subway) maps were more geographically accurate but terribly difficult to use. Modern maps use a more simplistic geometric design to aid people in understanding where they need to get off and on - each stop with a label.
I would argue the very words we use are a bunch of labels. Representations of things in the world and within us, linguistic maps. Often the most simple linguistic labels convey the greatest amount of meaning. "I", one simple letter, represents all of our personal human complexity. Should we ban the use of "I" in psychotherapeutic practice because of the inherent simplicity of the label? I would imagine some of the most meaningful deep expressions and understandings contain "I" in them. "I love you" a prominent (and simple) example.
This is why I find diagnosis conversation uninteresting. I think we are focusing on the labels themselves, rather than building maps from those labels.
Goodness, how much could psychotherapists learn from cartographers? Or from linguists? Learn ways to better help their clients express themselves and understand themselves?
Wow! Thank you Alex. Your response leads to important things. For me, the gold standard in describing the uniqueness of another human is ACCURATE EMPATHY. I define it as "an ever deepening, emotionally engaged understanding of the other's experience." It is not labeling because it makes use of the inner, type 1, nonconscious, survival-oriented, subcortical mind's native mode of association, metaphor, and imagery to gather and store information. In the same way, you mention "I" as an adequate descriptor for the uniqueness of a person because it makes use of that same associative mode of thought and yet admits that it is still inadequate in describing a person. I think appreciating this is one of the important things we all need to understand. Just as a picture is worth 1000 words, metaphorical truth is often more true than dry, logical truth. Jeffery
This made me think about how often breakthroughs come from borrowing ideas outside our own field instead of polishing the same debates. Some of the best questions sound a little ridiculous at first, right up until they lead somewhere nobody was expecting. That's usually where the interesting work starts.