Authenticity is a critical factor in clinical medicine, especially psychiatry and even more important in Addiction Psychiatry and Addiction Medicine. A number of the leading specialists in this field feel most strongly that if a practitioner is unwilling to self disclose their own struggle with addiction then they really don’t belong in the field.
It’s noted that in general medicine non compliance can range to 30% In psychiatry it’s not uncommonly 80% and it well can be argued that in Addiction Psychiatry it’s not uncommonly 100%. This gave rise to the development of motivational psychotherapy and a scale assessing willingness to change.
In contrast in general medicine where the patient is seeking help and has a particular complaint, this is increasingly less the case as clinicians are increasingly coopted by third parties to do their bidding rather than 'heal' which is what the doctor's original role was before the corruption. The 'voluntariness' of the patient, seeking help for a bio psycho social or physical or mental problems still exists. In Forensic Psychiatry by contrast, the psychiatrist is backed by jail and guns, the patient not being 'free' and care potentially 'coerced'. In addiction psychiatry there’s a peculiar dance in which the ‘therapeutic alliance’ is foundational and critical.
St. Paul, was the first Addiction Psychiatrist and said , Romans 7.20 "I do not understand what I do. For what I want to do I do not do, but what I hate I do."
Repeatedly studies of psychotherapeutic outcomes in psychotherapy and especially psychiatric psychotherapy and even more so Addiction Psychiatry/Medicine, has declared the critical importance of ‘authenticity’. Note that, in contrast to studies which historically declared doctors the most trusted of experts and lawyers the least trusted and politicians. Administrative medicine given it’s ’scripted’ association with the whims of politics and lack of scientific veracity, has yet no need for ‘authenticity’. Indeed 'in authentic doctors would likely be attracted to such an aloof in human field of scripts and obedience to the degree that Arendt described as 'banal'. The closer to the ‘police’ the administrative function is the less it requires “authenticity’. It doesn't directly serve the patient but serves the institution. Relying as Forensic Psychiatry does on ‘position authority’ and ‘weapons’ versus ’tools’, it really doesn't know the importance of 'authenticity' or 'spontaneity' . It doesn't even grasp the concept of 'therapeutic alliance' because it's focus is 'walls' and 'boundaries' rather than the kind of 'cooperative' process which occurs in frontline clinical work where individuals are not hierarchically established despite the 'talking points' presentation of this relationship based on 'cultural communism.'
The significance of ‘authenticity’ is further important given the rise in ‘fake news’. Ironically, a Harvard study found that some percentage akin to 75% of pro Hillary reporting and 75% of pro Republican reporting was ‘fake news’. More significantly the ‘fake news’ was remembered and more ‘effective’ than the truth in deciding election outcome.
Churchill said, ‘a lie gets halfway around the world before the truth has a chance to get its pants on." The great Nazi Marketting Guru, Goebels, said, "A lie told once remains a lie but a lie told a thousand times becomes the truth." and "the bigger the lie the more it will be believed."
Prof. Andrew Parker, Physiology, Anatomy and Genetics at Oxford discussed his fascinating study of brain activity using modern brain scanning techniques. They took Rembrant Paintings ones known to be authentic and ones known to be ‘fake’ and showed them to their subjects equally. He said it was unfortunate but that their subjects brains didn’t differentiate authentic and fake. What was most important was that when they were told that a copy was a fake the brain behaved differently. Indeed the ‘fake’ was made more memorable because the subjects seemed to be more interested what made it ‘fake’ rather than the ‘original’.
In clinical work, a patient faced with an ‘inauthentic’ or outright ‘lying’ clinician tends to focus most on that and not hear or pay much attention to the message after. This is especially true in the addiction field where patients have experienced significant trauma and know intuitively all the subtleties of in authenticity, like ‘damning with faint praise’, “trust me I’m here to help you”, "I'm not concerned for myself or seeking revenge I'm just concerned for others that they won't have to experience the terrible things I have."
An interesting study of administrative medicine showed that administrators were incapable of recognizing sociopaths which were readily identified by a judge. As a family physician I had difficulty understanding certain psychiatric patients referring several a year to psychiatrists. Now I have seen tens of thousands and spent 4 decades working with psychopaths, sociopaths, psychotics and addicted I'm very experienced in this process. I actually find alot of people rather 'loud' because they're literally shouting their psychopathology and neediness and showing all manner of verbal, non verbal behaviours usually without any insight whatsoever. Bullies are especially transparent. Lawyers and administration are often a bit amusing to a psychiatrist because they historically rely on the 19th century masculine idea of 'playing their cards close to their chest” when in fact they radiate 'tells' time and time again mostly because they are so often 'above the law' and lack the skills and fitnesse of those below them or the chameleon psychopaths who routinely use them. Sociopathic women, borderlines are very adept as playing to the sexual weaknesses of the older male authorities by suggestively implying that they find them sexually arousing and that if they're supportive they might well be rewarded. The whole 'victim' culture which has been described extensively as 'cultural marxism" and coopting feminism. (Fiamenco, Hoff Summers, Dana Davison etc).
The stigmatization of mentally ill and addicted patients has long been associated with an equal stigmatization of those who directly care for such people. Such care givers are used to the discrimination, the jokes, the demeaning and humiliation that their patients suffer. There's an element of fear which those unfamiliar with insanity have while those who are insane and especially the dementing are as bad as the 'lady that protestest too much."
Dr. Hannah Drayson, “The Experience of Spontaneity” , Digital Art and Technology, Plymouth University, talked about hypnosis and gave special reference to psychotherapy. Spontaneity is the antithesis of the Bureaucratic Administrative Process. Indeed the ‘spontaneity’ of President Trump has infuriated the entrenched methodical bureaucratic government awakening from the experience of 2 decades of Lawyer Presidents, Obama, the Clintons and the Bushs. The American populist reaction is simply a backlash against this perceived elite back room dealing.
Spontaneity is threatening to those ’stuck’. Studies show that ‘learned helplessness’ and the return to the ‘fetal position’ is more common than the idea of renewed ‘escape’ and ‘progress’. Apathy is the characterization of the Canadian population along with those in asylums and jails. It was the character of the ‘peasants’ both before and after the Revolution and Lenin’s symbolic and actual killing of the Czar , his wife and his children. The godless state has been more cruel than any godly state before. Yet Canada trends to this as did the European Union with it’s appalling layers upon layers of Brussels Bureaurocy. Dr. Phillip Ney has recorded that the numbing of the killing of abortion in a society has made the administration insensitive to the 'people'.
It’s sad really that Authenticity and Spontaneity, critical to psychiatric psychotherapy and especially Addiction Psychiatry have so little meaning to lawyers and administrators.
As I continued my walk along the Brunette River I was happy to see the green tinged Mallard male and his female mate. There’s a flock of these ducks that commonly make their home along this stretch.
I especially enjoyed seeing the Wood duck male, a very colourful fellow. It was my first sighting of him this spring. I’ve not seen the female. This is likely the couple that has nested the last two years in the little man made lagoon. I so enjoyed watching the couple with their ducklings. Tragically each year I’ve seen the ducklings go missing till none remained. I suspect a very happy coyote made that lagoon it’s dinner stop.
The mallards don’t seem to have this problem so I was glad to see the Wood Duck further down the stream. I do hope that the couple have learned that the lagoon is a bad neighbourhood.
I was blessed to see the Kingfisher darting by above the fast rushing stream. A couple of Kingfishers have made this river home. I’ve spent years trying to photograph them as the male seems always on the go.
The Great Blue Heron was there too. He actually let me take his picture. Last year I found his nest high up in the near by woods. I took a video of him lifting off and was so pleased with myself only to lose it when I didn’t back up my photos.
A number of us with dogs gathered and chatted about the day, dogs, plans, grand children, dogs, children, and dogs, WWIII unfolding, dogs, generally having a good chat. The dogs all licked genitals and sniffed asses. Rick was still wearing his pyjama bottoms. I came home for my second cup of coffee.
It was a great walk made better by the podcast and delightful first sightings of returning birds. The flowers are all blossoming. The daffodils are truly a delight. We are making plans to visit the Tulips near Abbotsford. Le Conner near Bellingham and now the Canadian Tulips are an annual wake up experience for the winter weary brain.
Spring is such a joy with all it’s authenticity and spontaneity.
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