Thursday, August 14, 2014

Ethics in Psychology

For those who know me, it is no secret that I have very little love for clinical psychology, particularly the kind that relies on bio-medical psychiatric practice.  For all of its ethical qualms when conducting research (e.g. the Stanford prison experiment atrocity) the great irony is that these limits further serve to enforce a standard of ‘culturally acceptable’ socialized behavior. Social standards and norms are not the product of some end all be all black and white morality; they are constructed by those who hold power and privilege.  Any type of therapy (be it cognitive, clinical, psychoanalytic, or even humanist) that strives to help make someone a functioning member of society is making the assumption that society is a greater good.
However I am a realist so I don’t think a completely excising the therapy model will do much good. People need to talk to people. Furthermore I believe in open dialogue for all things and viewpoints no matter how contentious they may seem to my personal worldview. However my problem with biomedical psychiatry, mood altering medicines, and drugs is that they change outlook and worldview before dialogue even has a chance to start. Sure, largely this is just used to alter serotonin levels nowadays to alleviate the symptoms of depression, but by changing how the mind works we change what it may conceive of and thus, ultimately say.  Would Poe still be Poe if he had taken his daily serotonin? It’s dangerous to tread into hypotheticals, but I don’t think it’s unreasonable to say that because of the drugs and our complicity in using the drugs we’ve lost a lot of ideas, and we’ve conformed to a lot of standards.

Let me be clear: Clinical Psychology like any medicinal practice is not The Devil. In my opinion it has done far more (subjective) good then bad. As someone who suffers from either Depression or mild Bi-Polar disorder (in my case it’s inconclusive as to which) I understand that help in whatever form it takes is an imperative. Recent high profile suicides (or any suicide really) should only cement that. However psychology is a tool, and like all tools it is most accessible to the powerful.

It’s tempting to think that because at its core it’s a medical treatment and thus designed to heal there can be no downsides, The professionals are only trying to help, right? Well historically homosexuality was considered to be a sign of mental instability. In fact the only reason we have the word ‘homosexual’ (or ‘heterosexual’ for that matter) was because the Victorian’s thought that they could ‘help’ by garnering a clear understanding of the differences between those nasty little sodomites. And for those that think the stigma against the Queer community must have lessened, the American Psychiatric Association only declassified it as pathology in 1973. While I don’t claim to be an expert on the taxonomy of psychiatric pathologies the timing was not an accident. After the Civil Rights movement keeping it as pathology was simply no longer culturally expedient.  Yes, this is a leap, but once again not an unreasonable one, so allow me another: at the end of the day, science can be made to say, or not say, more than I am comfortable with.

Here’s a modern day example: people with autism. Why did society decide that autism was a mental ‘disability’?  In fact a lot of people who fall on the autism spectrum do not consider it to be disabling at all and laugh at ‘neurotypicals’ trying to dictate to them how they should or should not be thinking. Sure the way society is slanted now makes it harder for them to socialize but so is the way society is slanted towards homosexuality. However since Disability Studies and advocacy of the kind that calls the majority hegemony ‘neurotypical’ did not exist until very recently the APA still sees patients rather than individuals. 

I guess the main point is: question everything. Even the most benevolent of organizations has biases. This is okay and inevitable, since everything, great or small is made up of people and their perceptions even-and this is important- even and especially ‘Ethics’. Just because the Psychiatric practice as a whole does not, and by definition cannot, follow an objective ‘good’ does not mean that one should not seek counseling. It’s pretty much imperative to seek counseling, if only to have some one to talk to.  However one should always seek it and the drugs associated with the understanding that they are entering into a system of control that serves those who can manipulate it presumably more efficiently than they can. Perhaps this is pessimistic, but despite all this perhaps mental health is worth it. Life is compromise, even when it comes to the subtlest workings of our freedoms. 

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