Modernism

 “In the varied topography of professional practice, there is a high, hard ground where practitioners can make effective use of research-based theory and technique, and there is a swampy lowland where situations are confusing “messes” incapable of technical solution.  The difficulty is that the problems of the high ground, however great their technical interest, are often relatively unimportant to clients or to the larger society, while in the swamp are problems of greatest human concern.”  (Donald Schon, 1930--1997)

Modernism, the prominent philosophic movement of the late 19^th and early 20^th century, embraced the promise of science and technology.  Science was believed to be the path to all meaningful knowledge.  Technology was believed to be the means to a better world for all.

In the day-to-day ethos of Western European culture, Modernism largely displaced religion, leading the German philosopher Nietzsche to pronounce that, “God is dead.”  The existentialist Nietzsche, though an avowed atheist, did not declare God’s death with joy, but with trepidation.  With the collapse of traditional religious values, he anticipated a great void, a void that science and technology could not fill.

Then came the horrors of a modernized 20^th century: two world wars, genocide, nuclear weapons, and environmental devastation on a global scale.  The world felt the void that Nietzsche had feared and prophesized.

For most of my career I worked in an academic, science-oriented milieu. Where I worked was committed to the values of Modernism, devoted to the belief that a better world, including better mental health, would come from science, research, and applied technology.

During my career as a child psychiatrist, I witnessed an exponential increase in scientific knowledge about the brain, about genetics, and about mental illness.  Some of what we learned was of great importance. We learned that autism is not caused by cold and rejecting parents.  We learned that schizophrenia is not caused by double-bind communication and schizophrenogenic parents.

However, along with the increased knowledge came an increased number of possible diagnoses and an increased number of children being diagnosed.  Unfortunately, a diagnosis doesn't necessarily translate to a better life.  It used to be rare to have 1 or 2 children in a school on Ritalin.  Now it is common to have 1 or 2 children in a classroom on stimulants or other psychotropic medications.

ADHD, autism, gender confusion, depression and suicide, drugs and alcohol, trauma and abuse; despite increased scientific knowledge the mental health challenges for children have only gotten worse. But why?

Modernism has fallen short of its promise. Science alone is not enough.  There is a piece missing. There is a game in academia called, "publish or perish." But much that gets published in the professional journals, though sounding quite erudite, is in reality quite trivial. Too much science and research pursues technical minutiae, all the while failing to wade into the "swampy lowland where situations are confusing." However, before we can discover better solutions, we must first learn to ask better questions, questions that address the "problems of greatest human concern."