Leaving Psychiatry. J. R. Ó’Braonáin. M.D.
years ago, being with a camping party in the mountains, I returned from a solitary ramble to find everyone engaged in a ferocious metaphysical dispute. The corpus of the dispute was a squirrel — a live squirrel supposed to be clinging to one side of a tree-trunk; while over against the tree’s opposite side a human being was imagined to stand. This human witness tries to get sight of the squirrel by moving rapidly round the tree, but no matter how fast he goes, the squirrel moves as fast in the opposite direction, and always keeps the tree between himself and the man, so that never a glimpse of him is caught. The resultant metaphysical problem now is this: DOES THE MAN GO ROUND THE SQUIRREL OR NOT? He goes round the tree, sure enough, and the squirrel is on the tree; but does he go round the squirrel? In the unlimited leisure of the wilderness, discussion had been worn threadbare. Everyone had taken sides, and was obstinate; and the numbers on both sides were even. Each side, when I appeared, therefore appealed to me to make it a majority. Mindful of the scholastic adage that whenever you meet a contradiction you must make a distinction, I immediately sought and found one, as follows: “Which party is right,” I said, “depends on what you PRACTICALLY MEAN by ‘going round’ the squirrel. If you mean passing from the north of him to the east, then to the south, then to the west, and then to the north of him again, obviously the man does go round him, for he occupies these successive positions. But if on the contrary you mean being first in front of him, then on the right of him, then behind him, then on his left, and finally in front again, it is quite as obvious that the man fails to go round him, for by the compensating movements the squirrel makes, he keeps his belly turned towards the man all the time, and his back turned away. Make the distinction, and there is no occasion for any farther dispute. You are both right and both wrong according as you conceive the verb ‘to go round’ in one practical fashion or the other.”“
In the above excerpt from James, his claim to truth and belief rest upon a clarity with which the problem is stated, and is a better illustration of what Peirce wished clearly to say. In what sense is the question asked, that the man goes around the squirrel? It hinges upon a definition of “going around”. There’s a third option also. After Einstein and without any aether or universal reference frame it might be as true to say that the man’s legs move yet he does not go anywhere, as the squirrel, tree and indeed the whole universe orbit around him. Perhaps in the 22nd century there can be additional formulations of man, squirrel and tree, bounded only by our imagination and the new scientific paradigms that may come…or may not as the case will be. But as is clear in the example and in further of James lectures, truth is not arrived at by a clear sense in which terms of the proposition are made. Neither does truth find it’s ground in clear grammar providing a correspondence between words about the world and the world as it is. No, for James truth is entirely instrumental. It is as true to say that man revolves around squirrel as squirrel revolves around man depending on the ends to which the question is asked and what one wants. James, in the land of the free marketeer capitalist and contra the Marxist temperament, even accords to truth the descriptor “cash value” and also additionally writes….
“Any idea upon which we can ride, so to speak; any idea that will carry us prosperously from any one part of our experience to any other part, linking things satisfactorily, working securely, simplifying, saving labor; is true for just so much, true in so far forth, true instrumentally. This is the ‘instrumental’ view of truth.”
And where the anti-communist conspiracy might have it (and probably has it correctly) that certain Marxist infiltrations entered into the universities, media and the like by Gramsci ‘s inspired “march through the institutions”, pragmatism also had its inroads into the same institutions in the United States by John Dewey and his disciples, even leading to the foundation of American public school education and social work.
Dewey, a democratic socialist with friends in high places and philosopher of many areas, was the last of the trio of classical pragmatists, classical pragmatism having taken root and flourishing as the first home grown American philosophy. Not surprising for an atheist, Dewey also rejected truth as an ontological, dare I say transcendent, state of affairs, that knowledge is or ought to be a correspondence between the reality out there and how it might be represented in the mind or the collective “sciences”. Instead truth was for Dewey, as it was for James and Peirce before him, that that is the case when we reliably get the outcome we are wanting. Truth is teleological where the architect of telos is mortal man.
Now I’m not stating that Pierce and James’ pragmatism was entirely as it could be cynically interpreted. On a deeper reading it was actually quite nuanced and I confess not to have read the entire corpus of their works. It’s entirely possible, though this is very much to be doubted, that somewhere they might have inserted a caveat not to be taken too seriously. That having been said, we are at least discussing the effects of their pragmatism, a reading of their pragmatism which by their own lights is the “cash value” of their philosophy on truth.
Now what on Earth has this to do with psychiatry I hear you ask.
Firstly, I take it as a given from my own experience that psychiatry has no faith or sincere interest in objective transcendent truth, never mind the good or the beautiful.
Secondly, I take it as a given that contemporary psychiatry is dominated by North America, its publication machine and the DSM. To the extent to which it exports its ideology beyond its borders and to the extent psychiatry is bio-political (as is certainly the case), American psychiatry colonizes other nations. It does this under the guise of caring words just as it does using propaganda words such as democracy, rights etc. And these other nations welcome becoming colonies.
Thirdly, when the effects of a various philosophies are found to be existing in an Anglo nation and can be attributed either to being manufactured locally or to have been imported from the European continent, it is the more parsimonious conclusion that the effects are from the local philosophy (i.e. pragmatism), though this of course is not to imply other influences are impossible (Marxism, postmodernism, other isms).
Fourth, Pragmatism qua truth being what is useful was an invitation to a power hungry hedonistic epistemology that was too much for modern (and post-modern) Americans to resist. It seeped into all areas of its culture and indeed even into psychiatry. It is evidenced by the words psychiatrists use. It placed a perverted epistemology in an unholy marriage with an ethics that would be unable to resist becoming perverted in kind. It is a question of human drives and motivations as to what people wish the truth to be in being directed to a desired end, ends often impacting upon other persons. In this sense pragmatism is necessarily a political philosophy. And the will towards a desired truth is the manifold upon which psychiatry can slide incoherently and effortlessly between appeals to reified truth as a science of the objective world (an appeal to scientific legitimacy), and also an appeal that the truth can be whatever is according to some other self serving end that it wishes (the continuance of power cloaked in the language of care, patient values etcetera). The truth is my truth. And who am I? I am the psychiatric guild. And the truth I trade in derives its “cash value” from verification. And who verifies? It is the guilds of psychiatry that verifies. If psychiatry verifies its own truths, it creates its own capital. And who owns the capital? The guilds do. Domestically they are monopolies. Internationally they are oligarchies. And then the public take these false “truths” as fact, via a focus on what the guilds call science at the time in a game when the doublethink makes opportune to invoke the word “science”. Surely this is an economy that can only survive as long as the metaphorical mint keeps printing the metaphorical cash, always borrowing on a future that never arrives, a society where the will to real truth has lost the “cash value” of a former age. This is the age where Oprah can speak of “my truth” and “your truth” with nary anyone taken aback at the horror of three hundred million truths, and few wishing to champion even the notion of “the truth”. This is the age where psychotherapies are more concerned with what “works for you”, as opposed to a confrontation with “what you are” or “who you should be”.
Fifth; Take a critical look at all the uses for the words pragmatic and pragmatism and their variants or subtexts in the psychiatric literature. It is everywhere. What follows is but one particularly egregious example from the Australian literature, a country where I once worked for a time, citing American psychiatric intelligentsia of course,