Begin
My experience of the mental heatlh care system began in 1964 (I think; might have been '65). I was then, of course, a consumer of those services. I went on to become also a provider. (Licensed MentaL Health counselor and Certified Addiction Specialist). I had significant tours of duty in a variety of treatment settings, ranging from special-ed high schools, to adolescent substance abuse treatment centers, to inpatient psychiatric hospital services, to name some of them. For several years I pursued psychoanalytic training at one Boston's several institutes. I saw clients in a private counseling practice.
Now
I have now been out of this work for many years, but the imprint of those experiences stays with me in that when I look out at the world and doings of fellow human beings I naturally frame those perceptions in terms of the root metaphors that governed my work in the field, as well as in my personal treatment. In retirement I remain a consumer of mental health services.
Let's start with a practical example. Two interlocutors square off with each other, each hurling the same accusation at the other, namely "You're deluded." Our protagonists have taken up diametrically opposed views of the same question. Is there any recourse to objective means of settling which is mentally ill, and which has formed a correct diagnois? Or, in keeping with the tenor of post-modern times, are all such disputes reducible to mere differences in taste?
In clinical settings delusions present as extremely recalcitrant to treatment, even, or especially, I should perhaps say. when they occur outside of psychotic disorders. Delusions of this type are relatively rare, but when they do present in the hospital they offer very useful occasions for study. Treatment typically devolves to management of the patient's ego-dystonic responses to his disorder.
Delusions occur in settings and contexts other than psychiatric; they can form into large scale "mass" social phenomena. These are, I think, also relatively rare. Following the mid-term elections of 2018 I produced a study of Trump Derangement Syndrome using the root metaphor of delusion. Lately I have noticed that TDS has been supplanted as the most prevalent political delusion in the US. Now one sees the question of the November 2020 presidential election as the axis on which diametrically opposed positions are taken up,