False Objects in an Emotional Economy

Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy

I had to train myself not to get too interested in their problems, and not to get sidetracked trying to be a semi-therapist.” DR. DONALD LEVIN, a psychiatrist whose practice no longer includes talk therapy. New York Times:
By GARDINER HARRIS
Published: March 5, 2011

Like many of the nation’s 48,000 psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient. 

Dr. Levin said that the quality of treatment he offers was poorer than when he was younger. For instance, he was trained to adopt an unhurried analytic calm during treatment sessions. “But my office is like a bus station now,” he said. “How can I have an analytic calm?”

And years ago, he often saw patients 10 or more times before arriving at a diagnosis. Now, he makes that decision in the first 45-minute visit. “You have to have a diagnosis to get paid,” he said with a shrug. “I play the game.”

The Levin’s youngest son, Matthew, is now training to be a psychiatrist, and Dr. Donald Levin said he hoped that his son would not feel his ambivalence about their profession since he will not have experienced an era when psychiatrists lavished time on every patient. Before the 1920s, many psychiatrists were stuck in asylums treating confined patients covered in filth, so most of the 20th century was unusually good for the profession.

In a telephone interview from the University of California, Irvine, where he is completing the last of his training to become a child and adolescent psychiatrist, Dr. Matthew Levin said, “I’m concerned that I may be put in a position where I’d be forced to sacrifice patient care to make a living, and I’m hoping to avoid that.”

The above small exert from an excellent article by writer Gardiner Harris, highlights the emotional price we pay for quantifying the human experience as if it were similar in substance to the objects our eyes perceive. In writing here of new concepts of perception I struggle to articulate a new paradigm that is shifting our sense of perception from a simple awareness of objects 'out there' to an appreciation of systemic interaction.

'What does that have to do with objects & what do you mean 'emotional economy,' you ask.

Systems theory is now suggesting that our normal sense of 'objectivity' is a surface perception evolved for immediate 'at first glance' survival and is defensively oriented. Neuroscience research is uncovering a deeper reality to our human existence and the essential part interpersonal affect-emotion plays in our sense of being human, indeed the brain itself matures in relationship with others, during the first three years of life.

In his book "Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development" Allan N Schore tells us "It now appears that affect is what is transacted within the mother - infant dyad" (P, 7.). Affect is understood to be the instinctual root of our complex of emotions, with Silvan Tomkins the father of Affect Theory noting only nine primary affects.

It appears that our very sense of being alive, indeed our essential wellbeing is founded on affective experience, for example our real sense of security is affected more by our proximity to others than the physical shelter of a home. Sensations of joy and empathetic connection are fundamental to our healthy existence and yet we confuse our real internal needs with external objects.

It appears that we automatically project our internal processes onto the external world, looking for the feedback that will sate our essential metabolic needs. Our need for safety is projected onto objects like man made structures, unaware of the internal stimulation of brain neurons and nervous system activity which powers our perceived wants. The metabolic processes of brain, heart & lungs essential to our survival are fundamentally unconscious, and it appears fundamentally misunderstood by a shallow conscious self awareness. 

Despite Moses injunction on the worship of false idols, we have built an economic system for survival based firmly on the transaction of objects, and in the example above a well intentioned, well trained psychiatrist laments his need to ‘play the game’ and dispense those small objects of chemical relief, while wondering whatever happened to his humanistic beliefs.

In his brilliant research on the human nervous system Stephen Porges has scientifically uncovered the biology of Sigmund Freud’s unconscious ’id’ showing us how we are still motivated more by instinct than intellect. In the combing of a wide variety of scientific disciplines systems theory is unveiling the true nature of reality, including our own. 

To paraphrase Bill Clinton’s ‘It’s the economy stupid,’ we are coming to understand that our experience is essentially systemic and that the shallow objective perception of the mind is defensively oriented towards detecting objects as threats and securing our immediate survival needs, while remaining unconscious to the nature of its own source.

‘It’s the nervous system stupid’ could be a new world catch phrase, as we search for the route to continued survival in this 21st century Ad, with Moses injunction revealed in its true nature by the wonder of our inquiring mind, at last inquiring into itself. Neuroception is our real perception in the foundational reality of systemic biology, and the polyvagal theory that led porges to coin that term, is where biology meets physics in further understanding the molecular level of consciouness and oneness.