Even more advanced medical treatment strategies, based on recent neurobiological discoveries hold great promise, if coupled with the healing presence of a “talking cure.” (psychotherapy). For instance, neuro-feedback procedures can be effective in the treatment of trauma, but should always be set within a broader psychotherapeutic context—so that the trauma can be better understood by the patient so that future behavior and decisions are not driven by re-experiencing of the trauma or even re-victimization.
Patients who must live with voices in their head, as a manifestation of schizophrenia, may find relief in taking one of the newly available psychotropic medications that are less numbing of mental and emotional functions than medications prescribed in the past. However, these schizophrenic patients are likely to live much more pleasant and productive lives if they learn (through therapy) how to adapt to their occasional voices (perhaps even having a “productive” conversation with these voices).
All of this suggests that the fourth assumptive world is regarded with justification as the “best” of the four worlds I have identified. It is certainly the most “modern” and “scientific” of the worlds. I applaud the many advances made in the medical treatment of psychopathy. Yet, I am reminded of Frank, the VA patient who I met in the surgery ward. Strapped to the bed, having been tearing off the skin on his arms and legs, Frank had been the beneficiary for many years of “medical treatment.” He had been hammered into a state of profound insanity by these healing “treatments.” A World War II victim of what would much later be labeled “PTSD”, I believe that he was being treated primarily for anger management when placed against his will in the hospital.
As a strong and unpredictably aggressive patient, Frank was no doubt a threatening presence on the VA ward; however, those providing “treatment” should not have been kidding themselves that they were trying to “cure” Frank – they were only trying to manage his behavior. Frank’s files were filled with the jargon of medicine and contained no reference to issues of behavior management and control. Employee safety is a legitimate reason to provide restraint—yet this rationale was never mentioned in Frank’s file. Our third assumptive world (social deviance) was alive and well (or not so “well”) in Frank’s hospital history—but it was never acknowledged. It was Frank’s file and his status as a patient strapped down to a bed that radicalized me. I think assumptions should be made explicit. If they remain unacknowledged, then they can do great damage, regardless of their initial benevolent intent.
I would go one step further. The hiding of an assumptive world and its unacknowledged beliefs and destructive practices is often motivated by money. Financial considerations have a way of distorting the management of both power and anxiety. I turn now to this matter of money.
