Dr. Patricia Farrell on Medika Life

Old Theories, Questionable Experts, and Mental Disturbances Need to Be Deconstructed

Too often, we cling to theories of mental disturbances, i.e., mental illness, to the detriment of individuals afflicted with disorders.

Zeitgeist is a word we don’t often use today, but it is as relevant today as it was when I attended graduate school. Yet, we continue to pursue treatments that may fail to explore too many roots of mental disturbances. I say “mental disturbances” because I deign to use “illness,” which seems illogical for a term that may have no relevance to what we’re describing.

Am I blind to the fact that the nosology of psychiatry/psychology requires this distinction? I don’t think so, and I question using a word that appears to have evidence of its biological or “unconscious” base.

Yes, biology is often seen as the cause of so many mental disturbances, but we are still walking in a dark room with our eyes shut on that one. For every “discovery” about a gene connection, we find it’s a dead-end where treatments fail, yet we continue with the treatments as though they will provide a cure. Some of the treatments bring on more symptoms that then require another treatment. Consider the rash of TD (tardive dyskinesia) medications we’re now seeing on TV. It is an iatrogenic disorder.

Today, my substack is prompted by reading about play therapy, its effectiveness, and where it originated. I believe it has a place in treatment for children, but I am also aware of the warped history that came before it.

One of the significant forces that sparked interest in this form of treatment was the Virginia Axline book “Dibs in Search of Self….” Greeted enthusiastically by the public and professionals alike, I don’t believe many looked critically at Axline’s portrayal of her treatment and the boy. I think it’s similar to the case of the Sybil books. Authors can take some liberties with their books, but not when people’s lives are at stake.

I’ll give one example of a problem with Axline’s book. Axline stated the therapeutic intervention lasted six months. I understand it took much longer than that, possibly years, and I have to ask if Axline or her editors made that change in the book. The second point is Axline’s theoretical basis for her interventions, both of which she fails to outline in her book. It’s more of a diary than anything else.

What prompted her to conceive her approach? The critical readers of her book have pointed out that she subscribed to the original idea of the “refrigerator mother.” Cold, emotionally distant mothers were the genesis of the syndrome. One of the strong proponents of this orientation was Bruno Bettelheim, a man discredited for plagiarism after his death when research regarding his book on fairy tales and, allegedly, brutal therapeutic treatments came to light. His book, “The Empty Fortress..” lays the blame for autism squarely on mothers.

Bettelheim appears to have had no training or credentialing in the techniques he espoused and may have given himself a c.v. that was replete with falsehoods. The image he created has been repeatedly questioned, and it is astonishing. Despite all of this, too many hold him in high regard.

Of course, the journal he wrote while in a German prison camp is something we should read. But, considering his slipping into unverified rhetoric, we have to question that, too.

Aside from Freud, Bettelheim, and Axline, we need to, as is being done now, begin the work of repair on theory and treatment of mental disorders. If they are illnesses, let’s say what causes them and, if they are more dependent on environmental issues, okay. More likely, any disturbance is multi-factorial, and many treatments will still not hit the mark solidly enough to “cure” these illnesses. As one patient told me, relief from his auditory hallucinations was what he wanted.

The future is bright and promising in terms of neurobiology and psychological treatments and, for that, we should be grateful. One instance of a book where I believe we can take comfort in parents’ ability to help autistic children is “Son Rise,” written many years ago. I recommend you read how dedication and consistent hard work with a child can have incredible results.

Remember that we create “gods” in medicine and psychology, and too many of them have feet of clay. Psychology has a few presently running around beating their chests like prominent warriors in the war for mental health treatments. But they may provide a crumb of an idea that can be extended to something worthwhile. Worshipping them without recognizing their humanity takes the wrong road on a dangerous highway.

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Pat Farrell PhD
Pat Farrell PhDhttps://medium.com/@drpatfarrell
I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.


Medika Editor: Mental Health

I'm a licensed psychologist in NJ/FL and have been in the field for over 30 years serving in most areas of mental health, psychiatry research, consulting, teaching (post-grad), private practice, consultant to WebMD and writing self-help books. Currently, I am concentrating on writing articles and books.

Patricia also acts in an editorial capacity for Medika's mental health articles, providing invaluable input on a wide range of mental health issues.

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