The 'psychiatrie problem: a lack of alternatives
Based on a cognitive (relational) learning model, the problem which psychiatry is confronted with is considered as being a problematic interaction between the individual with his behaviour-potential at one side, and the demands of the environment he lives in at the other side. Both of these poles determine each other. The interaction becomes problematic as soon as a lack of alternatives developes at one of them. This means that people who end up in psychiatry are mostly people who live in impossible situations: if people start deviating it is because their situation forces them to do so. The best solution will often be then to just change the environment in which they have to live. But even when their own behavior should change, this should be done by creating an environment which promotes and maintains more adequate behaviour, i.e. an environment that gives back to the individual the control over his own situation, by his own adequate behaviour. This cannot be achieved as long as we keep concentrating on the individual alone, continuing to define his problem as an illness. Therefore a plea is made for an attitude-change in givers as w ell as receivers of professional assistance, and for broadening the spectrum of psycho-social facilities, not within but without the medical- psychiatric framework. Special attention is given to the problems of the long-term hospitalised.