Meaning and Mechanism in Psychotherapy and General Psychiatry

Summary

A little knowledge is a dangerous thing

(Pope)

If a little knowledge is dangerous, where is the man who has so much as to be out of danger

(T. H. Huxley)

On New year's Eve 1992 a man suffering from schizophrenia climbed into a lions' cage at the London Zoo and was badly mauled. This event provoked a full-scale moral panic among the media and government, the tragedy seeming to violate many of the comfortable myths about progress in psychiatry, echoing the impact of the civil war in former Yugoslavia which had shattered the hope of an era of unbroken European peace following the end of the cold war. Whatever we may wish in reality the lion does not lie down with the lamb. Daniel the visionary, the interpreter of dreams, the one who asserted that his God, the God of angels and saints with power over man and beasts would eventually endure, while all earthly kings were found wanting, emerged from the lions' den unscathed—but secular, psychiatric, suffering, decarcerated, visionless, late-twentieth-century man does not.

In Daniel the vision and the reality, the soothsayer and the king, are kept separate. The story of the triumph of spiritual powers is perhaps a compensatory phantasy expressing the aspirations of an oppressed and displaced Jewish nation. In our society psychotherapists are cast in the role of visionaries, while psychiatry represents power and adaptation.