Defending Psychiatry

I often find myself in the unenviable position of defending psychiatry. This, in spite of the fact that I am not a psychiatrist nor do I even play one on TV.

Nevertheless, I feel compelled to speak on psychiatry’s behalf. Maybe it’s because when left to their own devices, psychiatrists aren’t very good at it. Or more likely it’s simply because an unreasonable number of people attack psychiatry unreasonably and I think someone ought to bring the concept of reason into the discussion.

Antipsychiatry

There is a faction of folks out there who are antipsychiatry and every time I mention them I get hate mail. But here I am again. Antipsychiatry. Antipsychiatry. Antipsychiatry.

Rather than give you my definition, which people hate and argue with, here are the central points of antipsychiatry according to Wikipedia:

  • The specific definitions of, or criteria for, hundreds of current psychiatric diagnoses or disorders are vague and arbitrary, leaving too much room for opinions and interpretations to meet basic scientific standards.
  • Prevailing psychiatric treatments are ultimately far more damaging than helpful to patients.

Some of antipsychiatry’s other opinions, according to Wikipedia, include:

  • Inappropriate and overuse of medical concepts and tools to understand the mind and society, including the miscategorization of normal reactions to extreme situations as psychiatric disorders
  • Unwillingness to develop and use objective tests (such as intelligence/cognitive tests) to determine patients’ state (such as strong psychosis)
  • Unexamined abuse or misuse of power over patients who are too often treated against their will
  • Relation of power between patients and psychiatrists, as well as the institutional environment, is too often experienced by patients as demeaning and controlling
  • Forced use of government (both civilian and military) psychiatric treatment prevents the patient from choosing private psychiatric or alternative treatment thereby denying the patient of his or her basic rights

You can read it all here.

I have dealt with many of these claims on occasion, but for now, let’s just say that while criticisms are a valid and useful agent of change, the approach taken by these groups leaves something to be desired.

Psychiatry is Perfect. I Love Psychiatry.

See, here’s the thing, psychiatry is neither perfect nor do I love it. Psychiatry is just a branch of medicine like oncology or cardiology. No branch of medicine is perfect nor do I have emotional attachment to any of them. They are just what they are. They are just areas of medicine where doctors try to make the best decisions they can based on the information they have available.

It’s pretty simple actually. No great conspiracy. No great cover-up. Just people doing the best they can.

Psychiatry is Imperfect

Psychiatry then, naturally, is imperfect. Wildly so. I have had encounters with psychiatrists that would curl your hair and make you turn your head around 360 degrees. Psychiatrists can be absolute assholes.

Among other things, psychiatrists tend to appear cold, unfeeling, callous, uninterested, uncaring, indignant and self-righteous to say nothing of poor bedside manner and a general lackadaisical attitude towards the concerns of the patient. Why so many of them are like this, I don’t know, but I suspect it has little to do with psychiatry and much to do with medicine in general.

But I digress.

Why Fight for Psychiatry?

[push]For every asshole psychiatrist, there are people with the opposite characteristics. Some psychiatrists do care, do listen and do take patient concerns seriously. These people deserve recognition.[/push]

That’s easy. Because for every psychiatrist that shows the characteristics above, there are people with the opposite characteristics. Some psychiatrists do care, do listen and do take patient concerns seriously. And even those who appear not to, they get the benefit of the doubt in my mind as doing the best they can. Like most human beings.

And to be clear, doctors went to school for more than a decade to be in a position to help you. Maybe they’re burned out, jaded and cynical at times but likely down there somewhere is a kernel of trying to help. Really. They are.

Psychiatrists Help People

Why Defend Psychiatry from Antipsychiatry FolksAnd they do. Psychiatrists help people every day. Every day they save lives. Every day they make lives better. Every day they make it possible for people to get jobs, have families and relationships. Every day they make it possible for a person to get out of the hospital, be safe and get better from an illness that would otherwise destroy them. Every day they make it possible for me to get out of bed in the morning.

So you see, it’s not that I love psychiatry. I don’t. I think they offer too many meds, not enough psychotherapy and allow insurance companies to dictate too many decisions. They’re not perfect. But no system is. Any medical specialty could be accused of the same.

But they’re worth standing up for because they are the last line of defense between the mentally ill and, well, often death, just like oncology is the last line of defense between cancer and death. They do an important job and fill and important role for people with a mental illness and don’t deserve to be demonized simply for being imperfect. Because not one of us meets that bar at work or anywhere else in life.


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