By Doctor Tom
More than a week later, the mass shootings at an Aurora, CO theater are still attracting the attention of a world that was already overflowing with bad news. As more information on James Eagan Holmes trickles in, he strikes me all the more as a typical schizophrenic of the type housed in state mental hospitals by the thousands in the Fifties; well before Ronald Reagan was elected Governor of California. The state had already started to slowly reduce the state hospital system then caring for thousands of inpatients considered too unstable to be managed at home. To single out Reagan for everything that transpired before and after his tenure would be to oversimplify some very complex issues; for example, both the state’s population and the number of patients in its state hospitals were increasing rapidly. From the mid-Fifties on, pressure to “de-institutionalize” mental patients for both humane and fiscal reasons had started to build with the availability of Phenothiazines, the first “tranquilizers.”
I would argue that a critical deficiency has been (and still is) the lack of a coherent classification for the conditions Psychiatry had been attempting to treat from the late Nineteenth Century on. The problem is readily understandable: emotional and behavioral problems simply do not lend themselves to the type of objective analysis Pathology provides so readily for the rest of clinical Medicine.
What I do hold Psychiatry and its affiliated disciplines responsible for is the delusion that the highly conjectural DSM system of classification they have been expanding since the Fifties allows the kind of objective clinical management other medical disciplines are able to provide.
The results of relying on an imprecise nosology have been chaotic; especially once the DSM began evolving into a mental illness “bible” for non-clinicians: police, judges, social workers, teachers and counselors who do have legitimate professional interests in the same general population, but are without the clinical focus physicians are traditionally expected to emphasize. Unfortunately, punishment has been emphasized at the expense of prevention and treatment and the latter have also been forced by prevailing dogma to conform to a punitive model.
One result is the controversy now swirling around James Eagan Holmes: people of varying backgrounds heatedly arguing over how an obvious schizophrenic should be managed within the Criminal Justice System. At the same time, there is meager discussion of the incredible ease with which disturbed people can purchase guns legally in the United States, which has the dubious honor of leading the world in gun ownership, gunshot deaths, and levels of incarceration.
On a related subject, we passed a Prohibition Amendment to our Constitution in 1918; after it failed to produce the utopian benefits predicted, we repealed it, but failed to notice that it had provided criminal gangs with a successful business model, one that could be readily adapted to other illegal markets, such as the one for “narcotics” created by the Harrison Act of 1914. In 1937, we created a criminal market for smoked “marijuana” (“reefer”) for devious reasons almost as an afterthought. When it suddenly expanded for no apparent reason in the Sixties, the problem was “fixed” with new legislation (The Controlled Substances Act) proposed by an Attorney General . Almost immediately, global criminal organizations were able to develop multiple illegal drug markets for the drugs the CSA prohibited (“controlled”); forty years later, they are still expanding, as the sheer number of “controlled” substances increases almost weekly and Marijuana, the most lucrative crop harvested in North America for over a decade, is also smuggled in massive amounts across our Southern border.
Neverteless, Right Wing politicians continue to demand more cops and bigger prisons, while their more timid opponents in “reform” damn “recreational” use without understanding that most chronic users (themselves included) were troubled adolescents who had tried “weed” before the age of 18 and have benefited substantially from its anxiolytic effects, which are far safer than those of other drugs, especially its 2 legal alternatives.
All of which prompts me to wonder if there is any hope for the survival of the smartest of mammalian species, the only one with the scientific skills that have allowed them to overpopulate the only planet available for the foreseeable future.
The stage now seems to be set for the most gripping human melodrama of all time: how will we deal with the global climate change we are producing? Unfortunately, before we can start correcting that problem, we will have to understand another: our own behavior.
