To get away from the concepts of norm and disease in psychiatry was proposed in the Public Chamber of the Russian Federation

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

On December 21, 2017, the Public Chamber hosted the Round Table "STOPSTIGMA: Time to Change, Time to Talk About It", where experts discussed the need to change the attitude of society towards mentally ill people.

The event was attended by members of the Public Chamber, journalists, psychiatrists and people with mental illness.

Under the plausible pretext of destigmatization of mental patients in society, at a round table in the Public Chamber of the Russian Federation, the idea was popularized that mental patients are almost the same people as everyone else. Mental patients are allegedly unfairly discriminated against in society (“stigmatized”). This means that you need to perceive them not as sick, but simply as “others” and protect them from undeservedly biased public opinion. You need to communicate with them in exactly the same way as with healthy people, these are not lepers, but simply others.

Olga Gracheva, Deputy Head of the Department of Labor and Social Protection of the Population of the City of Moscow, said "society must follow the path of tolerance and destroy stereotypes." “The very division“We are normal, but there are people with mental disorder”is wrong, it is stigmatizing,” said the journalist Daria Varlamova.

Irina Fufaeva, an employee of sociolinguistics at the Institute of Linguistics of the Russian State University for the Humanities, said that it is necessary to abandon psychiatric terms.

"The division is a norm and not a norm - this is a construction that must be deconstructed." Mental manifestations are a spectrum, a gradient, says Fufayeva. “There are no people with mental disorders, but there are people with certain manifestations,” she said.

Apparently, for greater persuasiveness and increasing emotional intensity, experts and psychiatrists invited people with mental disorders to the event. People came who declared themselves as "bipolar" (bipolar personality disorder), border guards ("borderline state of mind"). They gave very emotional speeches. After several speeches, the essence of which boiled down to demands to abolish stigmatization, recognize the presence of mental diversity and abolish the division of people into healthy and sick, experts again joined the case, who declared the need to urgently change the existing system of mental health care. Namely, to reform the institutions of orphanages-boarding schools (DDI) and psycho-neurological boarding schools (PNI) and involve non-profit organizations in the work.

IDEOLOGICAL BASE OF REFORMERS

The idea that norms and pathologies do not exist, but there is some kind of mental diversity, was at one time very actively promoted into the science of psychiatry by LGBT ideologists. True, this idea concerned only homosexuality at that time. The LGBT community needed it to remove homosexuality from the list of mental illnesses.

Now this idea has come in handy for those who have decided to completely reformat Russian psychiatry. And the past round table clearly defined the ideological forms that will accompany this reformatting. Participants called on the media to create a new image of people with mental disorders and in every possible way to follow the example of Western media, which have advanced far along this path.

Modern Western mass culture creates an increasingly attractive image of mentally ill people, said Igor Romanov, Dean of the Faculty of Communication Management at the Russian State Social University (RSSU), Ph. D. He talked about such a phenomenon as positive stigmatization. With positive stigmatism, "the image of a person with mental problems is the image of a person with certain advantages." “The topic of psychiatry has become popular in cinema. This is a completely different presentation today. Such that the viewer wants to be like that ", - said Romanov

Mentally ill people are not only indistinguishable from healthy people, but they "live more fulfilling lives than citizens without diagnoses," said Julia Guerra, documentary filmmaker and nominated for international festivals, a participant in the event. I wonder if the respected Yulia and the psychiatrists who were present at the event thought about such, for example, questions: among mentally ill people there are individuals who demonstrate symptomatology that is of little use for creating a romantic halo. There are citizens with severe forms of mental retardation, disinhibited, aggressive. Do these people also need to be recognized as healthy and to stop treating them? How will others need to behave with a person suffering from delusional disorder? Recognize his delusional constructs as an alternative way of perception and thinking?

ABOUT THE ESSENCE OF PAST AND FUTURE REFORMS

It is noteworthy that only one psychiatrist sitting in the hall objected to the calls of colleagues to abolish the mental norm.

“We, as doctors, in principle rely on the norm. When the patient gets better, he first separates himself from the disease. Now there is a trend when our colleagues want to change this position. But if this happens, we will all get confused and we will not be able to get out of it. You cannot go this way. We need to know what a norm is and what a disease is,”said Tatyana Krylatova, a pediatric psychiatrist, a researcher at the department of child psychiatry at the Federal State Budgetary Scientific Institution of National Center for Children's Psychiatry, to her colleagues.

It is worth noting that the reformers did not begin to destroy the mental health care system in Russia today. This process is carried out gradually and consistently, starting from the 90s of the last century.

Here is what Tatyana Krylatova writes about the process of destruction of child psychiatry in Russia in the article “Mental health is the guarantee of the country's prosperity, the sanity of politics and society”: “Since the 1990s, the processes of destruction of our developments and the heritage of national scientific schools have begun. A stream of missionaries, volunteers from pseudoscience, who were supported by various international organizations and foundations, poured into the country.

The motto of these organizations was not to interact with Russian scientific schools, but to search for vehicles for their ideas, even if among middle-level professionals. They shamelessly spoke about this to our faces. … These structures, as a rule, were hostile to traditional national schools, as they were seen as competent experts. They proved in every possible way that domestic science was outdated and worthless … … The result of such a massive attack was the destruction of the children's preventive service.

Psychological, medical and pedagogical centers over time were closed or reformatted, and medical specialists were withdrawn in the first place.

At the same time, various methods were used, including blackmail and intimidation. Immediately after the “dismantling” of our domestic structures, all kinds of SO NPOs, which were the conductors of foreign ideas, moved to their place.”

The introduction of the institute of general practitioners (GPs), carried out under pressure from the World Bank, was disastrous for domestic psychiatry. “The very name GENERAL PRACTICE DOCTOR or family doctor - means the treatment of the whole family, including children. Therefore, it is obvious that such a reorganization will also affect the children's link.

The created "family cyborg" will have to take into account all the nuances of child psychiatry, including age-related periodization of symptoms and syndromes, etc. Given the extremely wide range of responsibilities and competencies that a GP will have to possess, it is safe to say that his knowledge in the field of psychiatry and, in particular, in the field of child psychiatry, even after completing training, will be inferior to that of a psychiatrist, so wait You won't need full-fledged psychiatric help from GPs,”writes Tatyana Krylatova.

In her opinion, the PURPOSE OF THE CURRENT STAGE OF TRANSFORMATION was the concentration of psychiatric care in the hands of GPs. It all ends with the fact that "only a small remaining part of professional psychiatrists will serve seriously ill patients in a few hospitals and dispensaries," Krylatova is sure. The main burden of providing mental health care will fall on the shoulders of general practitioners who are not psychiatrists. They will, apparently, treat, proceeding from the new paradigm of the absence of concepts of norm and pathology, and not of patients, but of bright personalities with special thinking and perception.

The psychiatric reformers liked very much the words of one of the young ladies speaking at the round table with a diagnosis. “We don’t need your mercy,” she said to the public and demanded to abandon the use of some stigmatizing terms that mean mental pathology. The young lady who rejects mercy does not suspect that as soon as, under the motto of fighting stigma and discrimination, the mental health care system is destroyed, people with mental disorders will be sent to prisons and fed there with cheap tranquilizers. The treatment process will be easy, simple and without any mercy. The vector of reforming psychiatric care in Western countries is directed towards its archaization, towards a return to wild and simplified methods of treatment, towards rejection of the progressive achievements of the science of mental disorders, Krylatova writes in her article.

“The world is developing a tendency to develop psychiatric care in prisons, where informal citizens will be sent for isolation and“re-education”. Unfortunately, the logic of events leads from hospital to prison institutionalization,”Krylatova says.

By the way, blurring the concepts of norm and pathology can work in a somewhat unexpected way for us. Who said that the vagueness of the criteria for the disease will not allow, with a special desire and some ingenuity, to declare a mentally ill healthy person?

What, in general, can such reforms turn out to be for society? The destruction of psychiatry as a science and as a branch of clinical medicine is seen as a logical completion of the initiated transformations. After all, the main occupation of psychiatry is the study of the norm and deviations from it, it is the treatment of pathology. It is difficult to overestimate the powerful disorganizing potential that calls for the rejection of the definitions of mental health and pathology, calls for the destruction of generally accepted norms of behavior, perception and coexistence of individuals carry. in society. Is it possible in general to call the totality of individuals, deprived of any norms of relations that unite them, a society?