Saturday, October 16, 2010

Getting Through - Surviving Mental Illness 3

Maurice Neligan, 1937-2010, Heart Surgeon
Treating the Mentally Ill with Compassion

There is perhaps nothing as healing as a pleasant smile.  How often do we hear of the importance of a doctor's bedside manner?  Good communication with the patient is half of the battle in fighting any illness, be if physical or mental.  Patients are under enough pressure and stress without the hindrance of an impersonal professional.  General practitioners are always sympathetic listeners.  Those who do not possess people skills normally drop out of the profession or end up in medical research.  In the area of mental illness the need for a compassionate ear on the part of the mentgal health professional is a sine qua non.  On my own road to recovery from a bout of clinical depression some twelve years ago I can honestly say that the smiling face of my consultant psychiatrist and his ability to listen with great compassion was half the battle.

Maurice Neligan's  (R.I.P) final column from last Tuesday's Healthplus, the supplement to that day's The Irish Times is dedicated to the subject of mental health. He states that in his time studying medicine in the sixties of the last century psychiatry was a Cinderella subject looked on with suspicion.  Students at the time looked on this specialty as decidedly not popular and of lesser importance than the more prestigious specialties like surgery or neurology.  Those students, Neligan tells us, used to quip that psychiatry was "the care of the id by the odd."  He then goes on to quote from the great surgeon John Hunter (1728 – 1793) who wrote: "Perhaps there is nothing in nature more pleasing than the study of the human mind."  On the history of psychiatry, Neligan continues:

It has been a long and arduous road to the incorporation of psychiatry fully into the body of mainstream medicine.  Such illnesses are like most others - a mixture of genetic, social, biological and psychological functions.  The genesis of many psychiatric conditions is as yet poorly understood, but we must ensure that the treatment of those with such conditions is not allowed to be dealt with once more on the "out of sight, out of mind principle."  Society has for too long turned its back on such patients. (Quoted Healthplus Supplement, Tuesday 12th, page 20)
One can hardly disagree with this compassionate approach to those suffering from mental illness.  It is surely the legacy of the great pioneer of early medicine Hippocrates (ca. 460 BC – ca. 370 BC) himself whom I have spoken of at length in another post in these pages.

Neligan next discusses the contribution of the early pioneer Pierre Janet .  This Pierre Marie Félix Janet (1859 - 1947) was a pioneering French psychologist, philosopher and psychotherapist in the field of dissociation and traumatic memory. He was one of the first people to draw a connection between events in the subject's past life and his or her present day trauma, and coined the words ‘dissociation’ and ‘subconscious’. He studied under Jean-Martin Charcot at the Psychological Laboratory in Pitié-Salpêtrière Hospital, in Paris. In several ways, he preceded Sigmund Freud. Many consider Janet, rather than Freud, the true 'founder' of psychoanalysis and psychotherapy.  However, Janet made an interesting comment of how mental health is viewed from one class to another.  He argued that if a person is poor and mentally ill he is committed to an asylum as "psychotic."  If he s/he belongs to the middle or business classes s/he is diagnosed as "neurasthenic."  Finally, if a patient is from the upper classes and can be treated at home the patient is diagnosed as "eccentric."  (See The Irish Times Healthplus, Tuesday 12/10/2010, p. 20).

Maurice Neligan finished the last article he would ever write by wondering whether we were finally able to walk the walk as well as talk the talk with respect to mental health in Ireland.  One wonders if we are.

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