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    Covid Psychiatry: Meditations on a Pandemic
    Covid Psychiatry: Meditations on a Pandemic
    Covid Psychiatry: Meditations on a Pandemic
    Ebook130 pages1 hour

    Covid Psychiatry: Meditations on a Pandemic

    By Mark Morris

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    About this ebook

    Bacteria damage tissues through a sort of blunt force trauma. Viruses inject their genetic material into the cell, hijacking its internal functioning and re-purposing it to manufacture more viruses.
    The aim of this collection of short papers is to try to prevent the same thing happening psychically. To try to prevent our thinking being hijacked in the same way as the cell victim of the virus: Or at least to reflect on the process as it is happening.
    This book is a series of comments and discussion about the psychic effects of Covid as it affects us all, psychologically and culturally. Psychic effects as distinct from the physical effects on those who are unlucky enough to both catch the virus, and then have a bad reaction to it has, sadly, proven fatal to many.

    LanguageEnglish
    PublisherMark Morris
    Release dateAug 29, 2020
    ISBN9781005831011
    Covid Psychiatry: Meditations on a Pandemic
    Author

    Mark Morris

    Mark Morris is a psychiatrist and psychoanalyst living in the UK and working in the UK National Health Service in Cambridge as a Consultant Medical Psychotherapist. He trained in medicine and psychiatry in Glasgow, Scotland as the seventh generation through the University of Glasgow, although the others studied law. He moved to London in 1990 to train with the British Psychoanalytic Society and after training in the Cassel Hospital Richmond as a psychotherapist, he worked in the Charing Cross Gender Clinic and as a consultant in St Bernard's Hospital (the old Hanwell Asylum that housed Charlie Chaplains mother for a period) before moving to be the Director of Therapy in HMP Grendon, the internationally renown high secure prison treatment facility run as a set of therapeutic communities. Next he worked in the Tavistock/Portman clinic, another NHS forensic psychoanalytic unit before spending a decade in independent sector hospitals leading secure personality disorder units and hospitals, before returning to work in the NHS.His research interests have revolved around the personality of leadership, an subject in which he completed research doctorate in Keele University, and continental philosophy, particularly phenomenology, with its overlap into understanding psychiatry and psychopathology. He has written mainly on psychotherapeutic issues pertaining to working with people with personalty disorder and antisocial personality to date. Approaching retirement, he plans to write more, so watch this space.

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      Book preview

      Covid Psychiatry - Mark Morris

      Covid Psychiatry:

      Meditations on a Pandemic

      Mark G A Morris

      Covid Psychiatry:

      Meditations on a Pandemic

      Published ℗ 2020 by The Arlesey Press

      High Street Arlesey

      Bedfordshire

      arleseypress@gmail.com

      Categories. 1. Philosophy 2. Psychology 3. Sociology 4. Health

      Available in print (ISBN 9798673562994)

      Copyright ©2020 Mark G A Morris

      Covid Psychiatry:

      Meditations on a Pandemic

      Contents

      Introduction

      1. Covid neurosis

      2. Covid Psychosis

      3. Covid Mortality

      4. Covid Civil Society

      5. Covid Obedience

      6. Covid Incarceration

      7. Covid Leadership

      8. Covid Grief

      9. Covid Trauma

      10. Covid Psychopathy

      11. Covid Psychopathy

      12. Covid Neomodernity

      13. Covid Fatigue

      14. Covid Ennui

      15 Covid Denial

      16. Covid Renaissance

      17. Covid Philosophy

      Bibliography

      By the same writer

      Introduction: Covid Psychiatry

      Covid Psychiatry is a collection of short papers written during the 2020 Covid-19 pandemic, pasted up on a website with the same name. On its launch, a ttwitter comment opined that the Covid Psychiatry site articles didn’t seem to have much about psychiatry in them.

      The 1960s and 1970s was an odd time for psychiatry as a discipline. Fresh from enacting thousands of hideously disabling frontal lobotomies the previous decades, the first specifically effective medicines were coming on stream in the form of the antipsychotics and antidepressants. At the same time, with the psychedelic movement it seemed that everyone wanted to go psychotic; psychiatric rock stars in the form of Lacan in France, and RD Laing in the UK, proclaimed the core philosophical importance of the psychiatric, or through antipsychiatry, that psychosis was breakthrough not breakdown.

      In the US, psychological and psychodynamic therapies and counselling were much more widespread, probably legitimised by psychiatry. US psychiatry had been heavily influenced by the psychoanalytic diaspora fleeing the NAZIs, but then settling there. As a result, in the US there was a happy confusion of psychiatry and the psychotherapies, with psychiatrists being looked to like therapist life coaches, for opinions and remedies to all life’s ills.

      Anthony Clare, an Irish psychiatrist and broadcaster pulled together a number of these themes in 1976, in a book, Psychiatry in Dissent, where he distinguished between psychiatry extended vs. psychiatry focussed as it were. Focussed, psychiatry was a medical discipline dealing with the unfortunate small percentage of the population who are actively severely psychiatrically ill at any one time, requiring hospitalisation or medication. Psychiatry extended was everything else spanning its adoption by the then hippie and new age generation, to the worried well ruminating about their world in interminable therapies. The short essays in this collection might be understood

      d to be psychiatry extended.

      If focussed psychiatry involves the industry of the maintenance of mental health, and the care for those who have difficulties, then even this requires a conceptual expansion as mental health can be affected by so many different factors. The bio-psycho-social model developed by US Psychiatrist Carl Engel in the 1970s remains very influential, capturing the triune influences of mental welfare, prompting a liberal bias in the profession, seeing people break down as a consequence of the deleterious effects of poverty and social injustice. The emphasis the tripartite contribution also prevents psychiatry spinning off into becoming a branch of neurology on the one hand, viz. the disaster of frontal lobotomies; or psychology, such as in Chestnut Lodge Hospital in the US, where depressed patients were allegedly given long psychoanalytic treatments, where several months on an antidepressant would have been more effective.

      The writer’s medical/psychiatric specialism is known as medical psychotherapy, a small discipline, originally differentiated to ensure trainee psychiatrists gained some psychological or psychodynamic experience in, or perspective about their work of psychiatry before qualification. Latterly medical psychotherapists clinically lead the care pf people with personality disorder, who can fair poorly in generic psychiatry services, and whose management benefits from the added dimensions that a medical psychotherapists psychology/psychodynamic expertise brings to psychiatric practice. The medical psychotherapist adds to the three dimensionality of the bio-psycho-social the sociological of the medical model and local cultural; the interactional and perspectival of the influence of the observer; the psychiatrist, and their own attitudes, prejudices and indeed mental health or ill health.

      The senior/specialist training for medical psychotherapists is very similar to that of clinical psychologists, with three or four years full time rotating between different jobs where through an apprenticeship model. One learns a variety of approaches to and methodologies of psychological practice, applied in divergent clinical settings from a variety of masters.

      Down the road in practice, practically, the clinical activity between medical psychotherapy psychiatrists and clinical psychologists also looks similar, namely sitting talking to people therapeutically. This has led senior psychology colleagues and indeed policy makers and NHS managers, to question why medical psychotherapists earn more, being on a medical pay-scale rather than a psychology one. Pay differentials, of course, cannot be justified legitimately in any context (from each according to his ability, to each according to their need), but this does raise an interesting question of what the difference is; of what a medical and psychiatric training brings to a psychological therapeutic engagement with a patient.

      When the writer was training to be a psychoanalyst, there was a slightly uncomfortable dynamic between those analysts in training who were anthropology, sociology or philosophy graduates. These trainees had come to Freud and psychoanalysis through cultural studies, literary criticism or the humanities. This was distinct from those who were jobbing psychiatrists, psychologists or social workers working in NHS psychiatry. Many of the former had a deep literary understanding of psychosis, for example reading Freud’s commentary on the Schreiber case and indeed his autobiography itself, where as a senior Judge and with a final legal mind, Schreiber describes in forensic detail the delusional world into which he has fallen as he argues against his psychiatrists who have committed him to the asylum. Us more mundane NHS workers were unlikely to have heard of Schreiber, but were dealing with psychosis every day. There is a difference between the phenomenon in literary form on the page, and the reality of having to engage and work with the terrified patient living in their own world, invisible and incomprehensible to anyone but themselves.

      There is a similar dynamic with medicine; or with psychiatry and psychology. Most psychotherapists have the sense at times of holding the patient’s heart in their hands. Only medical ones will have actually had that experience concretely. The medical training and profession moulds one in a particular way as touched upon in the mortality essay in this collection. For example it seems to both sensitise and eviscerate the practitioner’s humanity at the same time. A medical student’s humanity is sensitised in that one works with people who are in pain; people who are suffering and people who are facing their own death. One cannot engage in such work without reflecting deeply on the meaning of it all, as one finds a way to engage, relate and stay with people in these terrible situations. But at the same time a medical training provides an alternative perspective, one of science; a perspective of anatomy, physiology, pathology, bacteriology; in the current situation, virology and immunology. Flipping over from the human to the scientific rational perspective, the doctor can escape from their traumatic empathetic resonance into a technical perspective through a scientific lens. Medically one has to see the situation simultaneously in an objective and dispassionate way.

      From the writer’s perspective, he’s got the best job in the world: One that sits at the epicentre of the human condition, where reality, sanity and madness intersect. Navigating this realm requires a familiarity with philosophy/ontology, the psychological, psychopathological (and particularly the writer’s own psychopathological as the lens through which the others are perceived) and the scientific/social/sociological.

      The subjects covered in these set of papers have not been about mental illness, or particularly about mental illness related to Covid. They are very much psychiatry extended, in the Anthony Clare sense, with the issues extended into the dimensionality that daily work at this epicentre illuminates.

      These short papers cover emergent themes during the first six months of the pandemic, using psychological, sociological and philosophical models and theories; but all from a particular perspective. From the perspective of an observer firstly trained in the science of the skull beneath the skin, secondly, trained in the insanity of the insane but thirdly, who has then specialised in the insanity of the sane. The writer hopes that perspectives from this fulcrum of the human condition has a legitimacy. The reader can judge.

      1. Covid Neurosis

      Covid neurosis was the first stage of psychological reaction to the

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