ABSTRACT

What the evolutionary dimension brings to the treatment of psychiatric disorders is a new perspective, a new orientation. Although psychiatry has long since abandoned the concept of demonic possession to account for the symptoms it endeavours to treat, it still approaches mental illness as if it were an enemy to be fought and overcome. The patient is expected to go through the rituals of consultation, ‘mental state’ examination and diagnosis, to collude with the psychiatrist in becoming detached and objective about his condition, and to place himself in the capable hands of the doctor and his team. The patient’s only responsibility in the matter is then to ‘keep taking the pills’. Many patients prefer it this way, finding it hard to accept responsibility for their circumstances, preferring to blame life events and other people for the way they feel, and to adopt a passive or dependent attitude to the psychiatrist who is willing to offer them treatment. For their part, psychiatrists, reliant as they are on the medical model, have encouraged this, because, like their patients, they can see little that is positive or meaningful in their clinical condition, only suffering, hopelessness and pain.