It forms the summarised reply by me to Wake-up call for British Psychiatry written by 38 Professors in British Psychiatry and published in 2008:
“In this short film, impossibly short for such a subject as mental suffering, I am going to offer you my own awakenings; awakenings that in fact go back many years before the July 2008 alarm call, claxon loud, made by 38 Professors in British Psychiatry.
In my last film, which covered the wide-ranging response to that wake-up call, I tried to present ontological reasoning in the background. However this was a mistake, as layering of personal narrative upon census view, at the same time as revealing wider academic endeavour was simply overwhelming.
At outset let me say that I thought the Wake-up call was a crudely written and narrowly based consideration. The wake-up academics certainly made some points that I agreed with, but others sat uncomfortably alongside patient experience, my journey of knowledge and the oath that I took: (above all) first do no harm. The wake-up call had for me the bedside manner of its much discussed sister paper, ‘What is the Core expertise of the psychiatrist.’
In giving you my views, I want you to know that I feel most uncomfortable. It is a scary task to challenge the collected wisdom of the 38 academics. As for the thoughts I have to make, it was only last week that Alec Salmond, Scotland’s First Minister reminded the reconvening parliament that nobody ‘has monopoly on wisdom.’ I give to you what follows only in that light.
In the next two minutes I shall offer ten summary thoughts regarding the 2008 wake-up to mental suffering and the variety of responses it generated:
ONE: Narrowness of vision. This can be said with certainty, as Professor Craddock takes every opportunity to discount philosophical breadth.
TWO: The Polymathematical. I am sorry, but in my strict terms, Femi Oyebode apart, the wake-up academics are not polymaths. Sadly, within psychiatry there are very few examples.
THREE: The ‘stand-alone’ brain in understanding. Here I ask you only to consider the proportionality of research effort. It seems to me that far too often this marginalises the reality of our social and cultural world.
FOUR: Consciousness. Every time I mention this, my colleagues groan. This perhaps tells us why it is universally ignored by the science of understanding. Research may be difficult, but human consciousness is surely not that of a rat.
FIVE: The objective-subjective divide. Here I appreciate the discomfort of Craddock. Just as he feels ‘caricatured’ as biological-reductionist, I feel reduced as offering nothing more than ‘subjective.’ In the 21st century is it not time to debate the usefulness of this terminology, as so suggested many years ago by Dr Allan Beveridge.
SIX: Disorder. Psychiatrists have no monopoly over the definition of ‘disorder.’ Here we all struggle. However imperfect we need classification but we must not attack one another if we disagree over dimensions. Rather we should debate.
SEVEN: History. Professor Craddock has repeated over and over that he is not interested in the past, and his view, it appears to me, is the prevailing one in our profession wide. The College has embraced the modern, multi-media techniques with its CME modules and podcasts, however look at the content. There is no history, except that of ancient lunacy laws. Where are the considerations of the changing classifications of mental illness, the social and cultural context of mental illness, the language of science and indeed any ideological considerations beyond the medical model. Holism, reductionism, ethics, philosophy, narrative medicine. They just are not there.
EIGHT: The overselling of neuro-scientific explanations. By this I repeat I am atheist, deplore mysticism, and share Professor Craddock’s wish for pragmatism. Science must not over-reach conclusion, for then it becomes scientism and we end up misleading ourselves. If you want examples send a postcard and I will send you a directory.
NINE: Humanities have capitulated to biology. Here I talk of the devolvement of our cultural and sociological worlds. These worlds are as real as the physical energies that invisibly govern so much of today’s technology and communication.
TEN: Reductionism. I deliberately conclude with this. Wholesale attack on reductionism is bad medicine. The remedy does not lie in abandoning reductionism where it is appropriate, but like Evidence-based medicine, we must recognise where it is necessary, but not sufficient. Let us accept that numbers (that which is quantifiable) and words (the qualitative) should be understood as equal forms of measurement. My life stands by this.