as a scientist will try to make an unbiased observation, an accurate diagnosis and to offer
the correct treatment (Littlewood and Lipsedge [1997] ch1, p11).

Here we see the basic principles of Western psychiatric practice:

ASSESSMENTof your medical history and 'an unbiased observation' on how you are
behaving in the initial interview with psychiatrists.

DIAGNOSISWhat the psychiatrist thinks you are suffering from ,using his catalogue of
mental illnesses, showing the recorded signs and symptoms listed in DSM
III [1987]

TREATMENTDrugs, psychotrophicmedication in most of cases. Some psychiatrists offer
psychotherapeutic interventions.

PROGNOSISNot a very good. More Kraepelin than Bleuer.

The psychiatrist Suman Fernando ([1991] ch5) has much to say about the 'imperialistic' nature of
Eurocentric classifications of mental illness, and whether such a Western view on mental illness
can be imposed on people of other races and cultures. He also advocates traditional treatments
for mental illness, stating that in rural societies the prognosis is better than in urban societies.

Philip Thomas quoting from the Mind Survey 1993 'Experiencing Psychiatry' gives users
opinions of psychiatrists, some good many critical.

'They have a set diagnosis which they work to and treat you with ECT and drugs.'

'They do not search out the reasons for your illness with you. So that the illness repeats
itself over and over again' ([1997] p5).

The basic treatment for schizophrenia is drugs without question. The Mind survey revealed
that treatment for schizophrenia was 98.6% treatment with drugs in the general user
population. 60% per cent of the people interviewed in the Mind survey reported receiving
psychotherapy or counselling.

(b) psychotherapeutic intervention

Klein was influenced by Freud's theory of the unconscious. Whereas Freud used the
technique of free association to reach the unconscious parts of the mind repressed or censored
by the actions of the superego, Klein used her own techniques. Working in a secluded space,
she observed children playing and developed the play technique. Using toys and
conversation, hers was a very dynamic therapy, openly interpreting the child's actions whilst
he/ she played. Klein joined in with the child's play when asked to. She looked at how the
child related to her, whether she was cast in any particular role. She also analysed how she
was made to act and feel. These are the 'transference' and 'counter-transference' roles Freud
had discovered in relationships between clients and analyst/ therapist.

Like Freud, Klein found that the unconscious phantasies, what was being repressed by the
super-ego, revealed itself in actions and words during the playing. Once child/ adult was
consciously aware of its own thought processes and unconscious phantasies, then the
therapeutic value, the change in the person's behaviour and thinking, could begin. Change is
brought about, as in Freud, by making the unconscious conscious. For Klein, to change is to
learn to act in relation to the other, rather than re-act, or play out past experiences and
relationships.

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