Thus, viewed in the cold light of evolutionary theory, modern psychiatry, in both its psychopharmacologic and psychotherapeutic aspects, is often in the business of making new and better defense mechanisms to help us bearers of the human hunter-gatherer genome to cope with our unprecedented social situation. We psychotherapists, from whose ranks the boundary violators usually come, try to reconstruct an Eden that never was, in which altruism and its accompanying warm feelings can operate unfettered by the context of real community and real participation in one another's lives. There is a regressive longing for the world of the perfectly nurtured child here, which is why speaking of the fallen psychiatrist and patient who act this out literally seems apt. Acted out or not, the psychotherapeutic Eden provides a respite from the anonymous post-industrial culture outside the door, an Eden wherein patient and therapist alike feel heard and are seen as people of individual worth rather than objects manipulated by market forces. Or, if society's demands remain beyond reach, perhaps stimulant medication can help you attain a more acceptable level of productivity, with the enhanced security and lifestyle options that accrue to those who can maintain it.
Myths can be life-giving at times, destructive at others.
If psychiatry has any remaining potential as a socially progressive force, this Eden is one myth we need to lose. We must awaken from the unconscious thrall it still has over our professional lives in the form of unexamined assumptions and misconceptions about the work we do. In its modern psychiatric and psychotherapeutic versions, the renascent Garden of Eden myth now serves to distract us from consciously integrating our own discoveries about who we humans really are and how we really got here. It obscures the truths about modern life that impinge equally on those psychiatrists who succeed and those whose careers visibly go off course. As responsible physicians we need, of course, to treat mental disorder, to prescribe medication, to perform psychotherapy.