Dr. Dan L. Edmunds, Ed.D,B.C.S.A.,DAPA.

Dr. Dan L. Edmunds, Ed.D,B.C.S.A.,DAPA.
e-mail: batushkad@yahoo.com

Thursday, October 11, 2007


One of my clients had posed to me some interesting thoughts. He expressed to me that he felt that in the past mental health professionals saw him 'as a dollar sign'. He told me he did not feel I viewed him in this way, however suggested that if I did not have a professional relationship I would probably not associate with him or others who are disadvantaged. It is unlikely I would encounter him outside of a professional relationship but I cannot say I am one who is an elitist.
This caused me to think about the issues of power and class and how they impact the therapeutic relationship. Within the current psychiatric establishment, the psychiatrist is almighty and holds all the power as well as the supposed knowledge to 'fix life' for the person. The problem is that much of what has led to individuals being oppressed, distressed, and disadvantaged was created by those in power. So, it is evident that those in power prey on the vulnerable, and only become more powerful.
It is necessary to eliminate hierarchies and the sense of power and control vested only in the psychiatrist or therapist. There must exist mutual understandings and sharing on an equal level.

-Dan L. Edmunds, Ed.D.

1 comment:

böse Fraulein said...

I agree with your statement concerning hierarchies and wish to explore it further. The power of the psychiatric hierarchy is guarded by the tremendous bureaucracy it has become. Isn't it funny that a bureaucracy is defined as a set of regulations used to control activity; characterized by divisions of responsibility, standardized procedures, a hierarchy, and most importantly... impersonal relationships.

Hierarchies in large state colleges, some churches, and of course psychiatry, all hide behind the confusion of the bureaucracy. Change is rendered impossible, and those at the top become so distanced from those at the bottom, neither sympathy nor understanding remains. Furthermore, If a bureaucracy is formed of different divisions that have lost touch with how to communicate information up or down the ladder, then those at the top of the hierarchy will not even be effected if someone is 'mislabeled' or 'lost'. They may not even know, and continue to self-righteously parade onward - suffering beneath unbeknownst to them.

Lets look at psychiatry and pretend we have an adolescent who is having trouble sitting still for long periods of time. At the top of the hierarchy we have the psychiatrist and/or pharmaceutical industry. In the middle we have different divisions of people involved - so here comes our bureaucracy. We have teachers, parents, a family doctor, peers, siblings...etc. Each group of people have different opinions and responsibilities in relation to the child.

The teacher needs to be able to instruct the child, but must also not allow the child to disrupt the others. The teacher, perhaps not trained in handling this child, may believe medication is necessary - but of course has no medical license and cannot make the decision to prescribe a drug. The parents, however, do not see how the child behaves in class (perhaps he behaves well at home), and do not want the child on medication. They, like the teacher, have no medical license and are not 100% certain what to do. The family doctor, uncertain of how the child behaves all day-every day at school AND at home, also can't be entirely sure what the best answer is. Everyone is left to their own devices, and they all look up the ladder to ask the "all-knowing" psychiatrist/therapist.

At the bottom of it all, we have the child... who ends up (often) without a say in the matter. Those closest to him, in confusion and good (and sometimes ill) intent, have asked someone even less-close to him to decide the matter. And why not, after all, that's what everyone else is doing. It is our responsibility to remember when everyone else is looking up the ladder, we oughta' give a glance downward as well and make the sure ladder is still on firm ground....