Vitality: A Psychiatrist's Answer to Life's Problems

By Richard Esser | Go to book overview

CHAPTER 7.
THE EXPERT IN LIVING

Why and how do people get trapped in the worst aspects of living? What underlies the different problems that a psychiatrist has to deal with? How can one explain the cause of such difficulties? It became increasingly clear to me that I had to have good answers to those questions if I were to know just what my expertise as a psychiatrist was.

For my job was to help people be rid of those difficulties. That is what was wanted from me as an expert. But to help people be rid of those difficulties I clearly had to have a good idea of what caused them. There could hardly be an elimination or a reversal of those difficulties without some idea of what led to them in the first place. Put more pointedly, I saw that the only criteria of the worth of any idea of causation was whether or not it served as the basis for the elimination or reversal of such difficulties. An idea of causation, seen this way, was clearly central to defining my expertise as a psychiatrist. However, coming up with such an idea left me facing a formidable problem.

For a psychiatrist’s expertise was generally considered to be an ability to make psychiatric diagnoses — and there were hundreds of psychiatric diagnoses. It seemed to me that those psychiatric diagnoses included every conceivable difficulty of human beings, from the slightest to the severest. Modern psychiatry was not limited to its original concerns with the diagnoses of psychoses and neuroses. It now encompassed a great sweep of the distresses, handicaps, shortcomings and failings of people. Alcohol abuse, narcotics

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