Therapeutic Madness. - book reviews

By John I. Lynch. Verlager Books, 1998. ISBN 0-9660249-0-7. 214 pp. Softcover, $12.95.

A classic joke among critics of the typical mental hospital today is: "The wrong people have the keys." To determine just how true this is, as well as to assess the competence level of the typical psychiatrist and his staff, all one has to do is visit some of these institutions, interview the doctors, and question the patient-inmates. Better still, the investigator-questioner should also interview ex-patients and ask them about their care and treatment. Whenever this is done (unfortunately such follow-ups are rarely, if ever, undertaken), the investigator invariably finds that "cures" of mental (or, rather, emotional) disorders and problems are the exception rather than the rule. Moreover, even though the patient is sent home he or she continues to take some sort of mind-medication for weeks, months, or even years.

Whether the "treatment" experience the mentally disordered receives at the hands of the therapist be that of medication, talk, or a combination of the two, makes little difference. Lasting behavior changes, restored emotional stability, and permanent calm and contentment are rarely seen. Though drugged and tranquilized, the client is, in no way, "cured." Unfortunately, people unfamiliar with modern psychiatry and clinical psychology and who have no understanding of what psychotherapists do with the "mentally ill" find it hard to accept the idea that most "mental" medicines, whether pills, talk, or both do not cure. Even more unfortunate is the fact that there is little in the way of published therapeutic standards, fail-safe or fool-proof treatment techniques, reliable and valid diagnostic tools, or Good Housekeeping Seals of Approval or Consumer Reports checklists to let the average citizen know whether the psychotherapist he employs is competent or a quack.

Without such needed guidelines and standards, every visit the emotionally disturbed individual makes to a psychiatrist or a psychologist - even those licensed and credentialed - is a crap shoot. Of course, one is usually and generally better off with the licensed and credentialed but such things in no way guarantee either competence, integrity, or the possibility of immediate or lasting help. Little wonder, therefore, that year-by-year the number of angry books written by victims of psychotherapeutic incompetence, malfeasance, and sadism continue to proliferate. John Lynch's Therapeutic Madness is one of the better additions to this genre.

Divided into three sections, Part I of Lynch's work describes in poignant detail what he and anyone suffering from a painful anxiety-driven case of obsessive compulsive disorder (OCD) experiences daily: how his successful professional life and ability to function were destroyed, and how he finally sought psychiatric help and acquired a therapist. The most tragic and disturbing part of the section details session-by-session descriptions of Lynch's incompetent (and herself mentally disturbed) therapist as she stumbles and bumbles her way from one therapeutic blunder to another. Then, when these efforts fail she then turns to her pill pouch and prescribes totally unnecessary and inappropriate tranquilizers and other neuroleptics to numb and stifle Lynch's superior intellect.

Much of the interpersonal interactions and conversational by-play between Lynch and his therapist is insane enough to serve as models for TV episodes of Seinfeld. Toward the end of the section the therapist's behavior becomes so bizarre the reader forgets that Lynch is supposed to be the patient! Most disturbing of all and a warning to those naive enough to believe that psychiatrist-patient confidentiality is sacred, the ease with which Lynch's therapist betrays his confidence is chilling. Most revealing is his therapist's total inability to understand and manage the emotional transference.

Part II is concerned with Lynch's attempt to determine if: 1) his mistreatment was par for the course; 2) if psychiatrists, as a group, are all as disturbed and incompetent as his own lemon; and 3) if the mental health system itself is basically flawed. Lynch accomplishes this with a short but incisive review of the antipsychiatry literature, the literature of psychiatric victimization, attacks on and criticism of the DSM (the Diagnostic and Statistical Manual), and pharmapsychiatry.

After emphasizing that self-help is not only possible but real and effective help, Part III of Lynch's book discusses how he managed to use his own religious beliefs and convictions, along with the staunch support of a loving wife, to help him overcome his anxieties and emotional distress. Lynch was fortunate, indeed, to discover that his personal God was a much better therapist than his psychiatrist Grace.

While many cautious readers might be inclined to assume that Grace, Lynch's confused therapist, is merely one "bad apple" in the large barrel of healthy and able psychotherapists, it is sobering to discover (along with Lynch) that all of Grace's superiors and other psychiatric consultants asked to review Lynch's records and treatment could find no fault with anything Grace did or did not do. Rest assured, in this instance the blind were, indeed, guiding the blind. Or it could be that the psychiatric referees were correct: Grace's incompetent efforts are, truly, the best that they can do.