Search for mental health; How does psychiatry help?

The Forest Hospital located in displaying the lanai presents the search for mental health and exploration of the newest advances in psychiatry. During this series physicians and other professional personnel working in the area of mental health at Forest Hospital a hundred bed treatment facility will discuss the latest advances in mental health care research and education. Such topics as alcoholism adolescent behavior marital problems problems of the aged suicide emotional problems and others will be presented on the search for mental help. Your host for this series is Mr. Morris Squire administrators of Forest Hospital. This is Mark Squire and our special guest for today is Dr. Jordan M. Sharon who is the psychiatric consultant to the Chicago Board of Health and to the St. Louis model cities program and the editor of The Journal of existential psychiatry. Doctor share around you has grown a legend and legend is one of the

provocative thinker evolve a new idea creator stimulator and enabler. And sometimes on the edge of psychiatry. Tell us what your present thoughts are in your own chosen field existential psychiatry. I mean wouldn't the direction it's hard to know how to reply. But I think I would more or less accept Actually the statements you make. I think let's take the last item first and say at least for the moment this question of perhaps being on the edge of psychiatry. I think there is some truth to this and I think that's a good thing in some ways to try to be somehow an anticipator from my own standpoint from a standpoint of brassica that we might go out of things that happen in psychiatry for example 10 years ago or so. I was on the edge of psychiatry in dealing with the way of looking at schizophrenia at that time.

The crowd approached the then current approach and which had been in existence for some time at that time. Well I was one out of the thought that all psychotic creations are in a world of their own they're out of contact with the rest of the world that we cannot inducer and force on them anything that they don't want to have they're unapproachable inaccessible at that time. One man named Rosen seem to be having some successes and beginning success with the idea of moving into the world of the psychotic as he put it. My feelings at that time were that Rose may very well be an affected man and I feel he was in yours and that this is a fascinating way of doing business. If it can be done I hope that from the general and broad standpoint I will ever in terms of dealing with schizophrenia patients such an approach would not have general applicability could not deal with the vast mass of the problem of the withdrawn individual who may be in his own world. I felt that that

to use the then current phrase of permissiveness was a way out of our allowing chaos to form an evolving chaos to continue to be chaotic. That if an individual comes to you with no clear definition of himself and he is involved in various imaginary excursions within his head that further cutting off from the real world. It was our job to intrude upon him to to form around him a structure that would call him back to the. Whirled around into the people around him into the dealings around him. I created of that time a concept of the structure of the ward and the structured approach now. My name is not necessarily associated with that word but I think you'll find my use of it was probably the first that it has come into existence since them in many areas has come into existence and dealing with children and another world that I created in that time because I thought we were doing in a similar way with the

concept of how dilatation. This concept also appeared I believe initially in one of my papers so the Friendly's role that I had was gadfly. I was someone who was willing to say our ignorance should not mean that we continue to promote chaos as a way of life and the findings that we had been dealing with people who could be called back who could be evoked back into a more orderly way of thinking and living. I was coming very much more into psychiatric thinking in general. Are we have now for example the so-called Reality Therapy which is a kind of take off on this whole general approach. We find many ways in which. An approach that I believe I certainly was one of the people instrumental in bringing into psychiatry as such are gained a certain amount of criticism and distain at that time because people didn't understand what it meant

to say that there is a true human being underneath these symptoms and that that true human being cries out to be reached. Not by jumping into his fantasy system and riding along with him and hoping you can chase him out of it but cries out to be reached as a young child cries out to be reached. Who refuses to. Who were in his own mind seems to want to possibly do what he wants to do at a particular moment and while his parent does not then just buy him a lollipop or get him a dress or take him to the movies or. Play the game the child wants he answers in a different way and says no this is what you really want. This is the structured way I think you're really wishing me to handle you and instantaneously miraculously the child becomes orderly and the child becomes related because the true message was not a given message. Now as I say at that time this was a friend's position to say the least. No longer no longer a French position so when you said I'm delighted I only hope that I am

still on the fringes because there's where psychiatry will be on what fringe are you now. Well you might say that but one of the friends is that I am on and have been on for some time is in the general realm of existential psychiatry as such. This is a way of life that is again creeping into the whole psychiatric curriculum by other names and it certainly began in some of these early experiences with schizophrenia and what not but I have the problem of the human being immersed in his world immersed in a world of uncertainty a world of of No. As it says in the Bible. Do not. Do not promise for tomorrow because I can't remember the exact quote and probably many things may happen between now and tomorrow. You cannot make your definite step in a definite program to say this is the way things are going in a forward moving direction as a human being. You cannot as the psychoanalytic

school largely promulgated and others have taken it up to say all we need to do to find out the answers to your problems is to find out what happened and to uncover and restore you to an understanding of your earliest most crucial relationships in life. The existence or positions of these things are neither a projection or predictions about the future have meaning. As such neither investigations of the past on related to and I'm involved in the current ongoing life have meaning. The only thing that has meaning. The only thing that was vital crucial essence is who and what are you now and how do you feel about yourself now. Do you feel that you are somehow in rhythm with things that you are out of rhythm and you feel that you are moving in accordance with the people around you. If that is or is not necessary do you feel that you have a sense of responsibility or self a sense of fullness in yourself a sense of clarity of identity

or do you feel constantly harassed and oppressed. Do you feel that. Involved with the jealousies about other people and what they're doing. Do you feel that you are always inferior to others or that you can't quite catch up with them or to the world as a really unknowing noble and unconcerned place. Are these your feelings in the world. If you are how do you react. Many people react by withdrawal by symptom formation and they react in many different ways. They come to a therapist many times any therapist with the idea of knowing themselves finding out about themselves which is also derived pretty largely from a psychoanalytic model where you go to a teacher a wise man who can tell you who you are of course was an absurdity. Nobody can tell you who you are you hardly know yourself and your teacher hardly knows who he is really. But. Involved in the contingent world involved in the uncertain world of moving forward and having a feeling

of moving at a pace that is somehow related to what's going on around you this I think is perhaps the best we can hope for as human beings. And you must run into a dead or an empty answer you must turn to a fourth definition a meaningless short cut or long cut as the case may be to feeling confident to feeling in phase with the rest of the world. When you go looking for information about yourself as though you were closed up boxes there were something empty that you could be put on a shelf in packs and say here's Johnny Jones he is a compulsive obsessive neurotic etc. or he is okay normal whatever that means. How people come as people to me and to any therapist to become themselves or to have more of a feeling of being themselves in relation to other selves to have more of a feeling of being able to move forward in their own existence as with satisfactions in terms of that to be able to face the uncertainties that they have to face in any circumstance. This is the essence of living

or a life living reasonable. How is this on the edge of psychiatry. Well that's why I say this is right and some ways right in the center of it. Psychiatry which for a long time felt very much involved with the I the organic School of Psychiatry which meant that you don't deal with a person and his definition of himself or in his way of looking at himself but you give him a lot of London lightning or thunder electroshock or something of the sort and this will knock such questions out of his head at least temporarily and there's some value in that. There are patients and there are situations when that's not inappropriate. Not everyone is a verbal communicator not everyone can or should deal with ideas or at least an ideas with all times. So one shouldn't necessarily rule out the meaning for use for immediate or short term purposes such things. And you deal today with more than one person within the therapy of your practice I always have.

I may deal with husband wife situations I may deal with the family situation I may deal with them separately or together. I made a deal with small groups I don't personally like dealing with a large group at a time because I think there are too many things going on. I think it's too complex a situation and I think much is lost in the interpersonal one to one arrangement. When you get the various groupings and ganging ups and there are some values in those two I know but I I don't feel as comfortable in massive communicative enterprises like this as smaller but some people like Ackerman various of the other physicians have said they can really make an adequate diagnosis until you have a total family. If I were a generation that I'm not even sure you can make an adequate diagnosis then you see what I think you're saying is that when you meet a particular person in his hear his viewpoint his world view you are cured in a certain direction and you know the person you're cured in his direction and another person he cured in his direction. Now I'm not so sure of the assemblage of these multiple directions as any more

accurate diagnosis. I think it's just an assemblage and what happens very often is the. And I'm not even sure diagnosis is vital actually as far as that's concerned. But what happens is very often in these multiple group things I believe is that the predominant constellations take charge of the whole operation. And you do not get closer to. Again you see we're almost tripped back into this knowledge model. How can we know what's going on we can't know what's going on we don't know what's going on. We're only involved in what's going on in one or another way. I mean a psychiatrist really does know what's going on I was a cutter doesn't know what's going on with a psychiatrist who says he does a liar. That's a surprising statement actually there. Well that's what I'm trying to say exactly. See how my own friends put this is one of the places a psychiatrist is a person skilled in certain kinds of experiences. And it's his skill in these experiences and in this kind of experiencing that makes him a value not his information.

Dr. Schauer I wonder with a man who was a psychiatrist very well trained and trained as you are was able to say that. You as a psychiatrist don't understand all of the things about people and thank you understand very few things about what's happening with people as they said. How do you feel that you can then judge mentally set on something called the St. Louis model citizens program. If I were to sit on a judge mentally I would upset myself and excuse myself very quickly. I think that we are a psychiatrist like any other specialist in his field has experience is how those fragments of information from the past as viewpoints has sex accessibility to various kinds of studies and the ongoing set the dealings with the body of knowledge that he is supposed to have some command and some command in an hour. When I deal with any particular unique human being or several human beings I can never anticipate really I mea hazard guesses about I may

presume to think that I can know this or that situation of response to this or that situation but I can really not. I have reverberations of things that happen in the past that give me clues about something to expect in this or that situation. And it is this capacity to have let's call it a trained assessing system not a system of specific knowledge but a system of ways of accepting and assimilating and of dealing with the oncoming information from other people. That is of vitality. In my dealings with a man in mind helping them deal with themselves I'm not dealing with them in terms of specific information so I'm not I'm not a dictionary I'm not a sourcebook for all this means this and therefore that means that and therefore if I push this word in that individual will suddenly become cured or whatever we want to call it. I am an experiencer who must be sensitive to the particular elements of this total human being as he wishes to present himself in as he wishes to conceal

himself at any given moment. And in this process if I am somewhat skillful as any other artist as skillful I help him move toward not my definition of his best purposes and his best self but his definition. In this regard how are you helping the St. Louis model and what is your ground. OK disregard the St. Louis model for this program for example who's faced with a very real problem trying in their terms to motivate a vast area of people who have dark drop to the bottom of the barrel in their own conceptions of themselves and their own abilities to see their futures as open to see their futures as capable of presenting possibilities of moving out into Or perhaps the middle class ranks of our society and even seeing themselves as real human beings and not just as beasts of burden. The bottom seven percent or beasts of labor yes these are beasts of welfare. These people. I have to

somehow come to a new view of themselves as human beings. Why. Why. Well that's a good question too. Actually let's change that they don't have to. But our society which is a militaristic society or society which is always looking for its highly future oriented in this highly upward mobility oriented presumes and declares that this bottom seven percent should be made accessible to and be allowed the fruits of the as equal rights as equal rights. So having fruits of the society in general. Now how do you get these people who've given up to want to move up again. Why do you have a responsibility towards us. I don't have a responsibility except as a human being. When they asked me to consult on some of these matters I feel a personal feel as a member of the American community as a whole evangelist college evangelist. OK I think that that there is a need a crying need of some kind here and I feel that

that not only myself but all people have certain skills should be involved in this real life struggle of this country is this. That this sounds like a good place for a psychiatrist to be moving in to where he can really help with attitudes of people who read. No I want a little time to really help he certainly should be one of the people called upon to try to help. Well how have you helped. Well I would really have helped. We're just beginning to get involved with this we're beginning to study what it means to be immersed in fixed attitudes. And so this is a beginning so start a beginning for him. I'd like to turn your attention if you can to another aspect of society that's upon us. And that's the aspect society that's out in front. There are people in our world who are living in a different world. People in our world who like you Haffner and people who are and various other can be called happy or can be who are on what's called acid or who

are in various kinds of modes but seem to be saying to us and they are saying to themselves that we're in front we're doing it as we see it. And you're way behind. What about what about. Well one of the things that a psychiatrist does not a should not be really I think in many ways is judge mental. And so it's not my role. I feel no particular evangelism toward They have no schools as I do perhaps toward the deprived schools. I think there is room I think we are in an extremely dynamic society. I think we're in a society that has no reasonable middle ground there's no place we can say here is where the middle is an everything that deviates from that is out. I think especially in a dynamic society such as ours there is a place for the Haight Asbury group. The people on the West Coast who are involved in any kind of a love culture of their own I would not necessarily join or be attracted to them particularly. But I think that they are trying to

express something they're trying to find something that you have never hedonistic operators. These are I think very often not. And and. Advance group of our society. I think they are the renegade conflicted compulsives who are very often you know if it were not for these rather sexual taboos and restrictions you have to I would not be the multimillionaire years. It's not because he is a prophet but because he is a banner behind behind which a number of people can hide who otherwise find difficulty masturbating in public and wishing to be masturbators in public and to admit to anyone they're really rather back door and back corner urges in these directions this is not freedom this is Gee maybe if we join have news banners mama won't look and spank us. I say this is a purist really kind. This is a purist the kind of effort to to

escape. But the really loaded with gifts of all kinds or looking at a gate fall in a magazine would not be Nirvana. Well what would you suspect would be a good way for us to allow this kind of release for the normal American. Well I demand anything wrong with the with Havner approach if that is a kind of release I think there's a more basic problem but I think the basic problem is the inhabitant inhabited kind of life we live in a world we live whereby a man can make it a million dollars because he tells people sex is OK. As though the rest of us have to as should be informed of this and he shows you pictures to prove it. Well is there some way we can and we can have a healthier attitude in our part time to help her out of times or something has become very very evolutionarily. It's not something we can command here advertise into existence. Actually the evangelist Hafner is doing something to bring about a healthier attitude. Even though his current supporters are largely derived from an unhealthy attitude I

think. But perhaps in time there will be a true freeing which will not result in promotional success on the part of so someone who fancies himself as a philosopher of sexual freedom. That's an interesting comment upon Iraq and St.. If you had the opportunity to build a psychiatric facility for the treatment of people what would you built. But I believe it's a good question too. I'm not sure what I would build I'm not really sure I would build a facility. I was my first time going to be on a seminar on Thursday night on the question of the law just acts of training for the young psychiatrist. I've been doing this question a lot of thought. What is a psychiatrist who is a psychiatrist and what are his needs and how many of them do we need and what is the function and purpose of other people practicing the tasks he says he fulfills with

kindness he fulfills inside not outside of facilities. Well we don't have much time but essentially. I think we're in a state of tremendous flux and so could you today. And second therapy perhaps in particular and in our attitudes toward patients vary too toward what we call mental illness. I think we have to do some awfully hard soul searching and thinking about what it is that we will miss. I know these words are now crusade. What is mental health. What isn't true on the mental illness of an individual. What kinds of facilities and external or internal we need. You sound like you're still a thinking man who I've always known. Thank you very much Dr. Jordan M. Cher. Thank you have a good consultant for the Chicago Board of Health. And on the St. Louis model cities program the editor of The Journal of existential psychiatry and his more squire for any additional information please write this program or to the

fourth possible plans online. You have just heard another in the series the search for a mental health produced by Forest Hospital in display in Illinois in cooperation with this station. During this series physicians and other professional personnel working in the area of mental health at Forest Hospital a hundred bed treatment facility well discuss the latest advances in mental health care research and education. Other topics such as alcoholism adolescent behavior and marital problems problems of the aged and others will be presented on the search for mental health. Your host for this series is Mr. Morris Squire administrator of Forest Hospital. The search for mental health is produced and directed by Jacques Rogge our this program was distributed by a national educational radio. This is the national educational radio network.