Is This What We Want?

But are we paying too high a price? Has "here's a prescription for 30 mg of Celexa, see you in three months" become the equivalent of "take two aspirin and call me in the morning?"

Author John Bentely Mays in his book, "In the Jaws of the Black Dogs" (Harper Collins, 1999), is after more than a simple magic pill. After a lifetime of depression, he demands nothing less than "the infinitely tedious...untangling of tiny self-hatreds and regrets, the legacies of a lifetime of attacking and abasing the self with the obscene language of the depressed."

Prozac, he tells us, only started to work the day he took it. "I cannot," he says, "rewrite the life-histories I have created ... before that time, reverse the damage I have wreaked upon myself, obliterate the terrible memories, get back to the pleasures and days I could have had."

No, instead of a super pill this guy needs a super man. Unfortunately for Mays, in his own words:

"Psychiatry is haunted by a dark dream of its own unreality as a medical discipline.

"In that nightmare, the psychiatrists see themselves at day's end, squatting in some lower ring of hell along with Victorian mind-curists, phrenologists, animal magnetism experts and other discredited would-be helpers, being poked and scolded unto eternity by the depressed and mad folk they did nothing for. Meanwhile, far overhead, flutters the smug angel of psychopharmacology - humourology, biodeterminism, call it what you will - tooting a tinny trumpet and proclaiming: Told you so!"

In his letter of resignation, Dr Mosher laments the fact that more and more psychiatry is disengaging itself from both the patient and the healing process. But even the most dedicated practitioners with no managed care company breathing down their necks would be hard-pressed to fill the very tall order of John Bentley Mays. And that brings us to the nub of the issue: Do we really want them to?

For Mosher's letter of resignation, click here.

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