Here’s how psychiatry can be applied to make sense of the violence.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
“Whenever men and women are prosecuted because of their race, religion, or political groups, that place—and that moment—become the center of the universe.”
- Eli Wiesel
In the first column on the Mideast crisis on Monday, we covered some of the basic and traditional ways that psychiatry can help. Perhaps there are more options that can be considered and tried in more innovative and experimental ways. After all, at its basis, such conflicts and aggressive behavior reflect our human nature. As Freud knew only too well, humans are capable of extreme violence and cruelty, and may even have a death wish (Thanatos). However, we also have the potential to cognitively override and adjust to these destructive tendencies if our basic psychiatric understanding of individuals and their care can be applicable to such large-scale crises.
Here may be some psychiatric insights that may be useful.
-Expert worsening before bettering. As in psychodynamic psychotherapy, suffering often worsens before improvement.
-Expect the unexpected and imagine the unimaginable. As in clinical care where innovation is often required for the unique needs of an individual patient, imagine the worse that can happen for social safety and security.
-Use the knowledge and power you have before it is too late. Delaying necessary psychiatric treatment often results in the need for inpatient care, let alone suicide and homicide risk.
-Mourn first, then find meaning second. We know that adequate mourning is necessary before being able to move onto necessary action, whether that is for an individual or a society.
-Groups can regress just like individuals. As Bion presented in his work on basic assumption groups, under threat, groups can also regress from their more higher function behavior.
-Prevention is better than cure. Avoid or give up chronic, ineffective social policies.
-If you want to know someone’s heart, know what breaks it. What brings them to cry about any social or individual challenge?
-Watch for the law of unintended consequences. Appropriate and helpful relationships may turn out to be inappropriate over time.
All these suggestions have to be viewed as possibilities to help solve major social conflicts and dangerous regressive group behavior, but perhaps worth trying.
Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry, and is now in retirement and refirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.