Beyond psychiatry

Dr David Enoch, 95, spent decades working as a distinguished psychiatrist and was consistently prominent in the battle for the mentally ill to be acknowledged and treated appropriately. He speaks to Christian Today about the relationship between faith and psychiatry, and his new memoir, Enoch's Walk – 95 Not Out: Journey of a Psychiatrist, published by Y Lolfa. 

CT: Was it your Christian faith that inspired you to enter into psychiatry?

David: My Christian faith did not inspire me to enter into psychiatry, but while psychiatry is an effective treatment in managing mental illness, my faith provided an additional resource.

It is noteworthy that both Freud and Jung, at the end of their careers, were accepting that psychiatry had been very special in removing symptoms but that the patients still remained unhappy.

Jung in particular stated that people from all the civilised nations of the earth had visited him at some time or other. All had fallen ill because they had lost that which all the great religions of the age had given to their followers and none had been really healed until they had regained their religious outlook.

CT: When you first entered the field of psychiatry, some of the practices that were standard at the time, like for example electroconvulsive therapy (ECT), are now viewed differently through a modern lens. What is your own feeling when you look back on some of these practices and their place in the evolution of modern psychiatry?

David: There are now treatments that have become defunct, including ECT as a norm, but for a minority of patients who have not responded to other treatments for depression, it remains a very effective treatment.

CT: Society at that time could be very unsympathetic towards people with mental health issues and the asylum was especially stigmatised. How did you feel about that when you first entered this field of work?

David: The social aspects of the time were against psychiatry, but I took part in the humanising of understanding about mental illness. There is still more to be done. Today the stigma is less, but still present in a significant degree and in spite of being aware of our own mental frailties.

CT: How do you view the role between psychiatry and faith?

David: First of all I am a doctor, medically trained, and mental illness is an illness like any other, requiring correct diagnosis and treatment. My own faith enabled me to offer a dimension of additional understanding to patients of faith.

CT: Sometimes mental health issues require the prescription of certain drugs. Does spiritual support still have a role to play in these cases?

David: Yes, even when patients are prescribed anti-depressants, it is essential that they are given at least supportive psychiatry and further psychotherapy during the acute phases or when there is an exacerbation of symptoms.

CT: Do you think any improvements could still be made in the field of modern psychiatry?

David: Improvements will be made as knowledge increases, but also more resources are required in terms of fully qualified staff and facilities so that everyone has access when needed.