Psychiatric Views on the Daily News - Episode 97

“We Stand With You”: The Struggle for Political and Psychological Freedom

President Biden’s speech in Poland concerning Ukraine carries greater messages for psychiatry.

PSYCHIATRIC VIEWS ON THE DAILY NEWS

In President Biden’s speech in Poland on Saturday about the Ukraine war, he started with a review of the recent struggles for freedom around the world. He went on to make the point that Russia broke their promise to not invade Ukraine while massed on the border. He claimed that the pain of the sanctions would hurt Russia. He reviewed the support and help of humanitarian and warfare supplies, but predicted that this struggle will take time to resolve.

As he spoke, so much reminded me of how challenging it often is to obtain freedom of the mind in our work with patients. Indeed, freedom of mind may often be our major therapeutic goal. The parallels in his speech were not only to history, but, as in parallel process, to our work. Such aspects as freedom—or lack thereof—as well as psychological pain, social support, and struggle, are common both in this war and psychiatry. Though rare in psychiatry, physical violence sometimes occurs here too.

Don’t prospective patients often hover over the border of getting help or not, with the result that about half never cross into treatment territory, but instead remain in the grip of control by their mental illness? Prospective patients can rationalize their choices.

Sometimes, as President Biden deliberates the use of more force, the force of commitment is necessary to prevent harm to self or others in our work. Delusions and hallucinations may prevent rational free choices, as can unconscious conflicts. Uncovering unconscious conflicts or dissociated traumatic memories can be quite painful before the relief sets in. Medication can have adverse effects besides the therapeutic ones.

The Russian propaganda has elements of cultish control of thinking. There is an information war going on, too. In psychiatry, where there should be no question that we can do better and need to consider constructive criticism, antipsychiatry movements often misinterpret information, doing more harm than good along the way.

Going off script at the end of his speech, Biden said that for more freedom, Putin cannot remain in power. His administration has tried to reframe and walk back what he said. Biden’s words to the world and our words in our work can be therapeutic or seem foolish. Words are their own kind of action.

“We Stand With You” was Biden’s closing message to Ukraine.

“We Stand With You” must always be our message to those struggling with mental illness.

“We Stand With You” must include our colleagues, especially those burning out nowadays.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues relate to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric TimesTM.