Searching for prevention

The pitfalls of prevention are how we commonly think of high‐risk groups, multideterminate causation, social change, community psychiatry and mental health. All of these pitfalls stem from a common trap in our thinking about living in terms of a cleavage between normality and abnormality. An alternative view of effective living is presented called The Vital Process . Vitality is seen as the key to prevention. Vitality emerges out of the challenge of facing our inner desperation. Living is making vitality out of desperation. We turn craziness into creativity, rage into courage, panic into initiative, violence into dynamism, hopelessness into achievement and self waste into self fulfillment. When we refuse to face our inner desperation we are at risk for its overwhelming us. Psychiatric diagnoses make this werse. They describe static pictures assumed to be abnormalities foreign to normal people. They make us more fearful and more blocked. The key to effecting prevention is making this idea of vitality central to our work roles. Doing this should replace the bureaucratic in our social institutions with a vital energy. The place for a vital psychiatry should be working directly in such social institutions and sharing responsibility for them. The path for changing these institutions is through leadership imbued with vitality. This in the end resolves into an issue of political leadership. The gain to be derived from such a rethinking of society is a greatly more effective mobilization of our human creativity resources. This is identical with preventing the psychiatric.