Psychiatry is the medicine of the mind, the science of psychic disorders and their healing, and its application.
Psychic disorders are dysfunctions of self-consciousness. We are conscious of ourselves to act voluntarily on ourselves in an appropriate way, to make good decisions, to give ourselves a good program of life. Psychic disorders appear when we no longer know how to use our consciousness to adapt to this reality that we are ourselves and to our environment.
Psychic disorders always involve emotional disorders, because emotional balance is both a condition and a consequence of the proper functioning of self-consciousness.
Self-consciousness is like a centralized administration in the brain, without a central administrator. An administration must inform itself about itself in order to act on itself, to administer itself. Psychic disorders are like an administration that no longer fulfills its functions because it no longer knows how to administer itself.
Self-consciousness keeps transforming itself every time one makes decisions. It wields great power over internal resources because it is in a central position, like a king in his kingdom. Like all power, it can be wielded for better or for worse. Psychic disorders have an unfortunate tendency to worsen of themselves because the power of consciousness ceases to fulfill its protective function, because it becomes a cause of aggravation of the disorders. The patient makes bad decisions. He chooses goals, beliefs and rules that prevent him from adapting to reality. He gives himself bad programs which lead to an increase in his sufferings.
Healing is always about restoring the proper functioning of self-consciousness, the ability to make good decisions to maintain emotional balance and live well, as much as possible.
Self-consciousness is a very powerful healing tool. By giving oneself a good therapeutic program, good rules, adapted goals, realistic beliefs, one can hope to cure most of the disorders. To be cured, one has to restore the protective functions of self-consciousness by replacing bad decisions with better ones. As decisions wield great power over all internal resources, they can be a very effective remedy.
When we have mental disorders, we are often overwhelmed by a feeling of helplessness, as if there is nothing we could do about our inner troubles. This feeling of helplessness is a factor of aggravation of the disorders: there is enough to go crazy when we say to ourselves that we cannot do anything whereas we cannot remain without doing anything. But this feeling of helplessness is also an illusion that must be dispelled. Decisions are naturally very powerful. As long as we do not lose the ability to make decisions and apply them, we do not lose their power. We feel reduced to helplessness because we do not know how to use our power, not because we have lost it.
Denial is like lying to oneself. We refuse to recognize truths we know or could know. We refuse to think about it. Desires and beliefs are repressed when it would be too painful to become aware of them.
Freedom of interpretation makes denial possible. An interpretation selects the beliefs it deems relevant and obscures the others. An observation which contradicts a desired interpretation may simply be discarded. We repress desires and beliefs by giving ourselves the interpretations that suit us and by refusing those that disturb us.
To know what moves us, we must always interpret the situation to relate the emotions we feel to what we perceive. It is often not difficult to identify the cause of an emotion, and the interpretation leaves no room for doubt. But it is also possible to have many illusions about the causes of our emotions (Gazzaniga 1998). We can attribute an emotion to a cause that did not trigger it. We can deny that we want what we want, by attributing our desire to a cause that has not awakened it.
Repressed desires and beliefs cannot affect us in the same way desires and beliefs that are consciously endorsed do, because they do not benefit from the power of decisions. But they can still have an effect by influencing other desires or other beliefs. One can give oneself honorable ends to satisfy other shameful and repressed ends without even realizing the deception with which one is fooling oneself. One can also ignore repressed beliefs that are the source of other consciously approved beliefs.
When repressed, desires and beliefs cannot be examined by consciousness. We cannot dispute them, criticize them, evaluate them, or reason about their consequences. They can exert their influence unbeknownst to consciousness as if they were the desires and beliefs of another person who dominates us, fools us and manipulates us. “The ego is not the master in its own house." (Freud 1915)
It is not biologically probable that the brain accommodates two competing centralized administrations, one conscious, the other unconscious. Unconscious beliefs and desires therefore have no direct access to control over all of our inner resources. To exercise their power, they must influence conscious desires or beliefs. They are like parasites of consciousness, as if they are harnessing the force of consciousness for their own ends.
The strength of the unconscious comes from the weakness of consciousness. By refusing to face reality, we allow ourselves to be dominated by unconscious forces. The unconscious is not like a foreign power destined to dominate us. Rather, it is the result of a surrender of power, because the consciousness cedes its power to it when it takes refuge in denial.
Denial prevents one from adapting to oneself and gives strength to the unconscious. It is produced by repression. Should we conclude from this that it is always wrong to repress?
It is wrong to repress only if it prevents us from adapting to reality. When repression easily leads to giving up desires that must be given up, it is of course highly desirable. We repress to maintain a good self-image. It is only a mistake if this image is too false, if it prevents us from adapting to the reality that we are for ourselves.
A remark on the unconscious: the theory of the unconscious is here a theory of beliefs and unconscious motivations. We can also reason on the cognitive unconscious: information is unconscious when it is present in the brain without the knowledge of consciousness. This definition poses a puzzle: where are the brain signals that carry the conscious information? And why do these signals become conscious while others remain unconscious?
The positive method is based on the following principle: we are better off with reassuring thoughts than with distressing ones, provided we face reality.
The positive method is generally ineffective to cure serious somatic (bodily) disorders, but it can still be effective, especially if the disorders are mild, thanks to psychosomatic effects. The production of hormones that regulate the functioning of the body depends on our emotions, and therefore on our thoughts. In addition, the nervous pathways are generally two-way. Since the nervous system innervates most of the body, all of our reactions can also depend on what we think.
The positive method has much more importance in psychiatry. Giving ourselves reassuring and realistic thoughts is part of the proper functioning of self-consciousness. Those who have little or no psychic disorders apply the positive method on a daily basis to overcome their anxiety in the face of life's difficulties. Anxiety disorders (the most common psychic disorders) appear when patients no longer know how to apply the positive method.
In psychiatry, it is very important not to make fun of the positive method. If we despise it, we can only worsen psychic disorders.
An example of the application of the positive method in a particularly painful situation: “Father, forgive them, for they know not what they do." (Luke, 23:34)
Dramatize when you need to play down.
To talk about the Oedipus complex when it only concerns ordinary emotional disorders of early childhood is to transform minor problems of everyday life into tragedy. This can only make the problems worse.
Disparaging the power of self-awareness.
To cure psychological disorders, one must always restore the natural powers of self-awareness. Making people believe that we are dominated by unconscious forces against which we can do nothing, or almost nothing, can only prevent us from healing.
Postulate the existence of natural self-destructive impulses.
All natural impulses are self-protective. Natural selection does not allow life forms that tend toward self-destruction to evolve. When self-destructive tendencies appear, it is always a dysfunction of our natural tendencies, not an inevitability imposed by Nature.