Democracy and Psychotherapy

I live in Spain, in a defective democracy. The political parties (mostly two of them) control the legislative and the executive powers. When a party holds the majority in parliament, it elects the president of the party as president of the government. Also, the president of the party strongly influences the list of party candidates to parliament (voters choose a closed list of candidates, not an individual MP from their constituency like in England). Then, the members of parliament systematically vote according to the instructions of the party and its leader. Thus a circle gets closed, with party, parliament and government controlled by a single person.

When no party holds the majority by itself, one of the big ones has to reach agreements with minority parties to place its leader in the presidency. Since the minority parties in Spain are either extreme national options or regional ones who don´t have the common interest at heart, this is also a problematic arrangement.

The judicial power too is influenced by party politics, as some of the most important magistrates are chosen by the legislative and executive powers. If the separation of powers has always been somewhat weak, the recent wave of illiberalism has made matters worse, enhancing the control of different state resources by a single person.

However, what I find most worrying in the Spanish democracy is the people themselves who are supposed to exercise the sovereignty. Without a long democratic tradition, nor a democratic character, the people are divided in two sides who oppose each other. We can frequently see actions that show that each side is more interested in harming the other than in achieving the common good. When cases of corruption emerge in one of the political parties, a large part of its voters subscribe the maxim “he may be a son of a bitch, but he is our son of a bitch”. Thus, when addressing the common responsibilities of building a society together, the Spanish can be considered failed citizens.

Growing up in this environment, I was very critical of democracy as a system, although I never went as a far as preferring a tyranny over it. However, this critical attitude was modified by my experience working in democratic therapeutic communities (DTC) in the United Kingdom.

A DTC is a clinical setting in which people can be treated for Psychiatric disorders. Leaving aside the possibility of receiving individual psychotherapy or pharmacological treatment, the characteristic feature of this setting is the treatment of and through the group by a community that works on itself. DTCs usually receive patients with severe Psychiatric disorders and an important social impairment which, in many ways, might make them failed citizens. The treatment facilitates their recovery towards a better mental health and full participation in the community.

Most Psychiatric institutions establish a vertical hierarchy, with professionals assuming power and responsibility over the patients under their care. This can be likened to an oligarchy, or to a monarchy if there is a single head, usually a doctor, on top of the pyramid. On the contrary, DTCs flatten the hierarchy and assign their members (or patients) the responsibility to run the place (including the household chores), to find agreements on the ways to live together, and to develop the institution that holds them all in their journey towards recovery. This aims to constitute a democracy in the purest sense of the term.

Professionals in a DTC are not meant to lead the community, but to enable its members to do it. Mirroring the structure of the Roman Republic, under extreme circumstances, horizontality might be abandoned to solve a crisis under the direction of the professionals. Once the emergency has passed, the egalitarian spirit is restored.

Members of a DTC develop themselves into capable participants of a community. They discuss the issues that affect them all, examine pros and cons, reflect on the impact that events might have on them (with a focus on their mental health) and work towards shared agreements.

The progress I saw in some members of DTCs made me think that, with adequate guide and support, most people are capable of becoming functional citizens and participate in a real democracy.

I understand that replicating a similar process of that of the DTCs in a country with millions of people might be more complicated. However, I think that the most troublesome part of it would be to find the therapists/politicians able and willing to help the citizens empower themselves at the expense of their leadership. The difficulty in finding them reeks of corruption in the democratic system. I am afraid this problem is found not only in Spain.

However, despite the difficulties, the example of DTCs shows us that it´s possible to work towards a democracy. I think it´s worth the effort.

Etiquetas: #psychiatry