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(289) Hirondelle

There is only one branch of medicine that does not have an equivalent in veterinary medicine—psychiatry. By apophatic reason, we can say that is where the division between man and animals lies—that he has a mind; and, ultimately, a soul. This should give us cause for doubt as regards psychiatry itself.

I flicked through the Oxford Handbook of Psychiatry and pretty much the first section asks “what is a disease?”. In keeping with democracy, it featured a poll where secondary school students, medical students, and doctors were asked whether various “diseases” were or were not diseases; notably, the school children were more moralistic in their thought; they didn’t regard alcoholism or depression as diseases, whereas doctors and medical students tended to do so. Undoubtedly, when you’ve seen the same thing over and over again you see its regularity and standard features—how it must be like a heart attack or cancer—whereas for most people alcoholism and depression fit into a willpower category, “cut it out” and “pull yourself together”.

The fact that the first question in the textbook was essentially philosophical—rather along the lines “what is a woman?” in the trans debate—was a reminder as to how far psychiatry is a vague and woolly subject (homosexuality—only a few decades ago a pathology, today practically a recommended activity for good people). It called to mind Crowley’s habit whereby he spoke of his dis-ease—to be ill is not to be at ease with oneself (and, from a psychiatric perspective, other people). There’s a whole medical field where people can’t even agree if what they treat is a disease or not—only that whatever they treat stops their patients functioning in today’s society in a way that is connected with their mind. For me, it just showed how limited science is—because when I flicked through the other pages “cures” were in short supply (as were causations). Man may well be “the sick animal”—his sickness is his soul.


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