Psychiatry Bashing

Last month (February 2016), the British Journal of Psychiatry published an online bulletin titled BASH: badmouthing, attitudes and stigmatisation in healthcare as experienced by medical students, by Ali Ajaz et al.  Here’s the abstract:

“Aims and method We used an online questionnaire to investigate medical students’ perceptions of the apparent hierarchy between specialties, whether they have witnessed disparaging comments (‘badmouthing’ or ‘bashing’) against other specialists and whether this has had an effect on their career choice.

Results In total, 960 students from 13 medical schools completed the questionnaire; they ranked medical specialties according to the level of badmouthing and answered questions on their experience of specialty bashing. Psychiatry and general practice attracted the greatest number of negative comments, which were made by academic staff, doctors and students. Twenty-seven per cent of students had changed their career choice as a direct result of bashing and a further 25.5% stated they were more likely to change their specialty choice. Although 80.5% of students condemned badmouthing as unprofessional, 71.5% believed that it is a routine part of practising medicine.

Clinical implications Bashing of psychiatry represents another form of stigmatisation that needs to be challenged in medical schools. It not only has an impact on recruitment into the specialty, but also has the wider effect of stigmatising people with mental health disorders.”

Note in the “Clinical implications”, the assertion that “bashing” psychiatry “has the wider effect of stigmatizing people with mental health disorders.”  This contention, which is widely promoted by psychiatry, is, I suggest, simply false.  Criticism of psychiatrists neither entails nor implies any criticism of their clients.  Indeed, within the anti-psychiatry movement, where the criticism of psychiatry finds its most vocal and ardent expression, psychiatry’s clients are routinely afforded a very high level of consideration and respect.  Indeed, it is my impression that more than half of the individuals associated with the anti-psychiatry movement are themselves former “patients”.

A second noteworthy matter is the use of the term “bash” in the title and in the Clinical implications section. The issue here is that it is apparently common practice in medical schools for students and faculty to make disparaging remarks about specialties other than their own.  It is also clear, from the survey itself, that the practice is not seen as particularly harmful or serious.

“The majority of comments (40.4%), either directly or indirectly, minimised any negative connotations associated with badmouthing other specialties or the impact on students’ future career choices. The most frequent comments stated that badmouthing was nothing but harmless fun and was done without any maleficent intentions. There was a real sense among some students that badmouthing was beneficial as a source of conversation and bonding within clinical teams. There was some recognition that some medical students might be influenced by the negative comments about certain specialties, but this was dismissed as being due to their own insecurities about their career choice rather than being affected by the remarks.”

Using the word “bashing” to describe this kind of activity constitutes overstatement to a misleading degree.  I have personally heard physicians make negative comments about psychiatry, but these have always been directed against the widely-acknowledged invalidity of its “diagnoses”, and the general lack of science in the development and assessment of its “treatments”.  It is interesting in this regard that two of the three examples Ajaz et al provide of psychiatry-bashing were:

  • ‘psychiatrists are not actual doctors’, and
  • ‘psychiatry – not real medicine’

And, seen in this regard, it is clear that such comments are warranted.  For decades, psychiatry has arbitrarily and self-servingly claimed as its legitimate domain all significant problems of thinking, feeling and/or behaving.  Within this domain, they have invented and promoted a truly bewildering array of fictitious illnesses, for each of which they falsely claim to have highly effective treatments in the form of neurotoxic drugs and high-voltage electric shocks to the brain.  Psychiatry has also conspired with pharma to produce a large body of fraudulent research and ghost-written books and papers to promote the sale of psychiatric drugs.  And on the wider scale, psychiatry’s “diagnoses” are inherently disempowering and stigmatizing, and serve to foster a culture of drug-induced dependency.

Psychiatry remains utterly deaf to these kinds of criticisms.  In fact, the more acutely and tellingly psychiatry is criticized, the more adamantly it defends its concepts and practices. But it seldom addresses the actual criticisms, relying instead on spin and on the endless regurgitation of the same tired old assertions:  we’re real doctors; we treat real illnesses; our treatments are effective; and – as in the present context – we deserve more respect.

. . . . . . . . . . . . . . . .

All of this is very interesting, but there’s more.  On February 27, the Royal College of Psychiatrists (the British equivalent of the APA) issued a press  release on the Ajaz et al study.  The release is titled Royal College calls for an end to ‘Bashing’ Psychiatrists

Here are some quotes, interspersed with my thoughts and observations.

“The stigma surrounding psychiatry doesn’t begin and end with the experiences of patients; doctors too experience stigmatisation – for deciding to become psychiatrists.”

Note again, the spurious linking of the disparagement of psychiatrists with the stigmatization that attaches in some contexts to psychiatry’s clients.  In reality, the primary source of the stigmatization of their clients is psychiatry’s long-standing, though false, insistence that these individuals have incurable brain illnesses for which they need to take pills for the rest of their lives (Angermeyer et al, 2011; Deacon, BJ, 2013; Read, J, et al, 2006).

. . . . . . . . . . . . . . . .

“Medical students and trainee doctors are reporting that the badmouthing of certain medical disciplines is impacting on their freedom to choose psychiatry as a speciality, and the higher echelons of this specialist branch of medicine are fighting back.”

This is a truly extraordinary statement.  Medical students and trainee doctors are reporting that negative comments about psychiatry that they hear around the colleges are impacting on their freedom to choose psychiatry as a specialty!  Impacting on their freedom to choose!  The poor lambs!  Those mean ol’ real doctors just keep picking on them, and you know, they just don’t know what to do with their lives.  Shouldn’t this be a “diagnosis” for DSM-6:  Excessive-insecurity-about-vocational-choice disorder?  But have no fear my little lambs, your leaders are fighting back!

. . . . . . . . . . . . . . . .

“President of the Royal College of Psychiatrists, Professor Sir Simon Wessely is launching a campaign to support medical students and trainee doctors by exposing the practice of badmouthing – known as ‘bashing’ – that threatens to deplete an already under-subscribed medical specialism.”

So, in the best tradition of St. George the Dragonslayer, Sir Simon is going to “expose” psychiatry bashing.  I wonder how that will work?  Posting on bulletins the names of offenders?  Public denouncements of psychiatry-bashers at the beginnings of lectures?  Confessions from repentant bashers aired on campus media?  And of course, an army of volunteer snitches.  “Please, Sir, Dr. Wessely, in the cafeteria this morning I heard Rodney Thornwhistle saying that psychiatrists aren’t real doctors.”

And undoubtedly, psychiatric action will be swift and decisive.  “Don’t worry, Willis, I’ll have the bounder stripped of his honors and drummed out of the college within the hour.”

“Oh, thank you Dr. Wessely.  It’s been so upsetting;  I hardly know what to do with myself.”

“Well take a few days off, Willis.  We don’t want you contracting PTSD, do we?”

“Oh, thank you, Dr. Wessely.  It’s such a comfort to have a person of your understanding at the helm.”

. . . . . . . . . . . . . . . .

“Psychiatry continues to face a worldwide problem with recruitment. In the UK, the Royal College of Psychiatrists has maintained an active recruitment programme for several years, but rates of students interested in psychiatry as a career remain at 4-5%; insufficient to meet future needs.”

Arguably, the single most important factor in human endeavors is the ability to deal rationally and self-critically with our failings, personally and organizationally.  Psychiatry is failing because it is everywhere being exposed as the facile and destructive hoax that it is.  But psychiatry has always been averse to anything remotely akin to critical self-scrutiny.  So they blame their decline on others.  And here we see this process plumbing the very depths of inanity:  recruitment is down because of the mean things that people are saying to psychiatry students in the medical schools!

. . . . . . . . . . . . . . . .

“Professor Wessely said:  ‘There is no psychiatrist in the land who cannot remember the reactions they received from some colleagues – especially the senior ones – when they announced that they wanted to pursue a career in psychiatry.  A bit of humour is all very well, but behind this is something unacceptable – an implication that the best and brightest doctors are somehow wasting their time in psychiatry. This has to stop, and this campaign is going to do that. People with mental disorders – just like those with physical disorders – deserve the best minds to find new treatments and provide the best care.’  He will launch the campaign on Saturday 27 February at the National Student Psychiatry Conference 2016 in Edinburgh.”

Note the dictatorial tone:  “This has to stop”!

And the grandiosity:  “this campaign is going to do that.”

So the Royal College of Psychiatrists is launching a campaign that will stop medical students and trainee physicians from ribbing each other concerning their chosen specialties.  Why not start with something easy, like world peace?

. . . . . . . . . . . . . . . .

But there’s more!  On March 2, BMJ Careers ran a piece on Dr. Wessely’s anti-bashing campaign.  The article is titled Stop bashing psychiatry, royal college urges medical students.  Here are some quotes:

“‘The current generation of students don’t put up with the things we used to,” Wessely told BMJ Careers. ‘Derogatory comments about race, sexuality, and gender are not common now, and when they do occur students complain. We want them to become the people who call others out when they denigrate psychiatry and mental health.'”

Isn’t that the most delightful piece of spin.  So for a medical student or trainee physician to assert that psychiatry isn’t real medicine or that psychiatrists are not actual doctors is akin to slurs based on race, sexual preference, or gender.  Equating interdisciplinary college banter with the exploitation, victimization, and at times downright savagery, that has in the past been directed towards the groups mentioned is, I suggest, insulting to the point of obscenity.

And isn’t it particularly interesting that a growing number of psychiatry’s former “patients” are recognizing that the “diagnostic” labels conferred on them by psychiatrists were (and are) inherently disparaging, disempowering, and stigmatizing, often permanently!

Dr. Wessely is essentially calling for a kind of thought police mentality in Britain’s medical schools.  Students are encouraged to “call out” those who breach the code of silence by describing psychiatry as the unscientific non-medical hoax that it is.

. . . . . . . . . . . . . . . .

“He [Dr. Wessely] added, “’I remember being told that I would be wasted in psychiatry because I was too smart. What that says is that mentally ill patients only deserve crap doctors.'”

No, Dr. Wessely, that’s not what it means.  It means that psychiatry is a destructive, hocus-pocus, facile sorting activity which assigns so-called diagnoses, and distributes neurotoxic drugs to people whose problems are not medical in nature.  It is not intellectually challenging to even a moderate degree.  In fact, its primary requirement is the “ability” to systematically blind one’s cognitive capacities to its total lack of intellectual and conceptual rigor.

. . . . . . . . . . . . . . . .

“As part of the campaign, the college will be working with mental health charities and medical school deans to drive home the message that bashing psychiatry is no longer acceptable, and Wessely will be visiting every UK medical school to discuss the issues.”

Visiting every medical school in the UK to stamp out interdisciplinary ribbing!  What an extraordinary way for a person of Dr. Wessely’s stature to spend his time.  Does he actually imagine that he can achieve this?  Or that even if he did succeed in eradicating this kind of thing, that it would make the slightest difference to psychiatry’s status or to its ever-downward trajectory?

Perhaps we’re witnessing the death-throes of a profession.  Locked irrevocably to a bio-bio-bio ideology; buffeted on all sides by critics, including some from within; and with no defense to the conceptual and practical criticisms, they tilt at the flimsy windmills of college banter in their futile drive to establish their medical bona fides.  As if saying it often enough, and with sufficient conviction, will make it so.

. . . . . . . . . . . . . . . .

But there’s more!  Dr. Wessely’s campaign to exorcise anti-psychiatry banter has its own tee shirt!

As often happens in criticizing psychiatry, I don’t know whether to laugh or cry!

  • S Randolph Kretchmar

    Man!!! I want one of those t-shirts so bad…

  • S Randolph Kretchmar

    I might also add that the third of the three examples Ajaz et al provide of psychiatry-bashing — ‘psychiatrists are crazy themselves’ – is just as clearly warranted as the first two.

  • bulbous1

    I’m not sure I agree that clients are routinely treated with respect by people within the so-called anti-psychiatry “movement”, which if it can be called a movement at all is certainly one with fissiparous tendencies.

    I say this because it is all well and good to call upon others to exercise greater self-scrutiny, but unless we do so ourselves, aren’t we just “pots jeering at kettles” (La Rochefoucauld)?

    For the sake of clarification, I use the term “we” not because I in anyway pledge an allegiance to any group, nor to any reformation project or revolution, both because of the knowledge that, in the former case, the reformer usually ends up spreading the plague to which he proffers a cure; and in the latter because, owing to the fact that an idea (no matter how pure) is inevitably corrupted immediately it becomes common property, revolutions can’t succeed, for the revolutionary masses – be the idea they take up “equality”, “patriotism”, “universal love”, “compassion”, “liberty”, “tolerance”, and so on and so forth – always end by betraying the ideas that animate the founding of the revolutions they so violently prosecute through to their bloody conclusions (be it literally speaking or metaphorically so).

    Contradiction in terms though it may be, I’m a one man movement, disabused of the fairy tales that propel people into the great projects and endeavors, such as the betterment of the species; advancing my own interests and desires, and sod all else, of the belief as I am that what men call their convictions – that is, their convictions of good and evil – are mostly only “a particular view of our personal advantage, either practical or emotional” (Conrad), whence the confusion about good and evil, notions of which are as inevitably varied as are the ends of men.

    Coming back to what I was saying, there is a tendency in some circles, for example, to dismiss mental patients as benefit frauds; to treat them simply as misbehaving children; to make invidious comparisons; and to identify personal suffering with personal failure. Now, if you believe those things, fine, but it’s not necessarily respectful!

    In the interests of fairness it must be stated that the disproportion between the amount we scrutinize others and ourselves holds good for all of us.

    That being said, these high-ranking psychiatrists are particularly bad though. Paraphrasing La Rochefoucauld, none are so frequently wrong as those who will not admit they are wrong.

    The problem is that if they were to actually have an honest reckoning with themselves, they’d likely commit suicide en masse! What happens, I would surmise, is that contrary to the notion that they are brainwashed and live in some sort of informational vacuum, they are regularly exposed to counter-evidence and objections that threaten their own beliefs, but directly they are, the self-preservation instinct kicks in, or some physiological mechanism is triggered, and because they cannot absorb the new information into the fabric of their thoughts without serious psychological and professional ramifications, they immediately set about rationalizing away anything that might upset the soil in which the beliefs they have become so invested in have put down such strong roots, whereupon – assuming they are wrong – they become downright delusional, as can be seen with Wessely, whose comments disclose delusional thought processes of the persecutory variety.

    Hence the utter absurdity of any attempted dialogue with them, which of course has provided MIA with a convenient pretext for the purging of undesirables (replicating the exclusion to which such people are subjected in society) and a rationalization, I would surmise, for the grisly accommodations the community has made with the very people they should be speaking out against, whilst acquiescing to or partaking in the exclusion of the people they oppress (and MIA is a classic example of just how the masses abuse the finer ideals and inevitably put them to perverted usage, for words like “equality”, “justice” and “tolerance” ring hollow when uttered in the mouths of people who support censorship, who discriminate in favor of people on the grounds of sex and color, and so on and so forth, do they not?). Of course this latter fact casts an absurd complexion on the claim made by many of its members that it gives a voice to the voiceless, a claim oft-made.

  • Zoe

    The bones of this is quite worrying; free-thinking and free-speech seem to be rapidly deteriorating!

    There is a flaw in Dr. Wessley’s plan however…

    1. People don’t take kindly to snitches.

    2. Criticism may be banned, but if the profession is given its own special ‘security’ that renders it impenetrable, it won’t win those professionals any friends (surely no law on campus can dictates who students must be friends with).

    As for low numbers of students studying this profession being blamed on ‘psychiatry bashing’… the majority of students are intelligent people who put forward intelligent arguments… more likely that this ‘psychiatry bashing’ is simply a case of ‘debating’. And having given the matter more thought, students with half-a-brain-cell have realised how damaging the practice of psychiatry is.

    The humour really brightens these articles and makes them enjoyable to read. Hopefully this one will find its way onto campus!

  • Zoe

    This news is good to hear (not about Dr. Wessley’s campaign, but that the profession appears to be struggling, and that young people are waking-up to long-term implications of signing-up to the profession).

  • all too easy

    Gosh you are hysterical

    love ya clyde unless of course he was obsequious and prolonging painfully bazaar retro-reactions of various kinds, led primarily and fundamentally, albeit it at times rather dubiously reluctantly, often when pleading for a more pleasing partition of sundry projects normally delegated in layman’s terms, if you will, if i remember correctly from the latter part of my interrupted perilous youth previously referred to as childish immaturity, more often than it deserves, regardless who defines all those less equal to me

  • bulbous1

    Whilst there is always a disproportion between the amount of scrutiny a man subjects to himself and others, this is more marked amongst the masses in society, and a fortiori under democratic dispensations, I would surmise.

    This marked disproportion can be seen in their tendency to scapegoat, a feature of social life that shouldn’t escape the more gimlet-eyed observer of the tragi-farce of human life.

    Exemplary in this regards is the pervasive and indiscriminate usage of terms such as “snob” and “pretentious”, and phrases such as “la-di-da”, to denigrate people who refuse to requite the respect that the masses DON’T show for the tastes of others, and who, on the contrary are fanatically opposed to just about anything they can’t understand, and to human differences generally, availing themselves of every avenue at their disposal for the enforcement of the moral, political, and expressional norms and conventions of society, bringing to bear upon each member thereof the full weight of popular sentiment and opinion, and using its power to prosecute the war on the individual waged in every age, every society.

    Such is the extremity of self-blindness to which the masses – made arrogant by their numerical preponderance and the flatteries of the many courtiers seeking to inveigle themselves into Hydra’s good graces and the sycophants soliciting its patronage – are compelled by their amour-propre, and such is their sense of entitlement, they genuinely buy into the assumption that they and their kind are humble and non-judgmental, and riding a wave of self-righteous indignation, attack any who look down on their tastes, as they attack any mind that ventures off the well beaten path the herd mind traipses.

    It puts in me in mind of an early script by Ingmar Bergman, The Fish, in which the protagonist goes out for a stroll, only to encounter wherever he goes the malicious laughter and boorish bellowings of the mob. Thereupon the poor man resolves to avenge himself, and after paying them back in their own coin, is set upon by an indignant mob.

    This a drama that plays out in every society. Society assigns you to some demeaning, degrading role, and the moment you fight back, they take umbrage, the hypocrites.

    This can be seen in the case of the lover of high culture, an object of derision in every society who, immediately he requites the sentiment, is symbolically lynched.

    What bothers them is not that such people look down on the vulgar aliments wherewith the masses sate their senses, no; it is that they consider it lese majeste for those whom they perceive to be their inferiors to give themselves ideas above their “proper” station.

    What offends us about arrogance is not arrogance per se but that someone who seems to us (in our own arrogance) inferior would dare to love themselves when we deem such behavior to be only “truly” befitting ourselves, and under cover of offended humility, we set about trying to make the perpetrator of the offense against our amour-propre hate himself as much as we hate him.

    No matter how much the masses make a pretense of offended humility, they are worse than the people they denounce, and have no right to expect respect from those to whom they show none.

  • Phil_Hickey

    Zoe,

    Thanks for coming in. One of the mainstays of psychiatry for the past 50 years has been the systematic repression of concepts and viewpoints that don’t support their agenda. I frequently get emails from people who work in mental health centers or similar agencies, who agree with what I write, but who are afraid to speak out for fear of losing their jobs.

    Best wishes.

  • Zoe

    Dr. Hickey,

    I wish I could say I’m surprised. But I have experience with other public sectors that are harming people, and employees don’t speak out against the systems in that they work for fear of ‘consequences’. And it doesn’t just happen in the work-place. Many people who experience injustice daren’t speak out, for fear of making matters worse.

    These systems that are harming people seem to be entirely money motivated, with little regard for social wellbeing. But then, why should they be, when social unhappiness is so profitable.

    And it would seem the more insecure and miserable society is, the easier it is to control; stress causes inability to function properly, which leads to state dependency, and vices (that are also profitable, and that damage people’s health, in doing so ‘keeping down the numbers’). Furthermore, whilst people are unable to reach their potentials, they are less likely to poke their noses into the area of business and politics).

    People who work in the mental health sector, might not feel they are in a position to speak formally or publicly against the system in that they work, but that doesn’t mean they can’t raise awareness in other ways…

    They can raise awareness anonymously, by using their talents to think outside the box: An illustrator, for instance, could draw cartoons that make people smile… as with ‘Auntiepsychiatry.com’ that you have pointed us to… a writer could write a book or blog… a person who can edit home movies could create a humorous or evocative You Tube video (they wouldn’t need to star in it). And a person with determination and time could source information and personal stories, and share them on social media sites… all of which repeat a consistent message, and can be done anonymously.

    I think since people have become more vocal on social media platforms (and websites such as this) this is likely why psychiatrists are now feeling-the-heat. Until in recent years, the practice has been pretty much unchallenged by the media (save for the odd bread-crumb).

    It’s good to know that professionals such as yourself are brave enough to speak-out. I look forward to your next article!

    Best wishes

  • Zoe

    Dr. Hickey,

    Just to add, my last comment was aimed more at people who might be reading the comments. It’s a topic that frustrates me, and I wish that people would see the bigger picture.

    Thought I’d better add this, as in hind-sight it does look rather condescending!

  • Zoe

    Dr. Hickey,

    Just to add, my last comment was aimed more at people who might be reading the comments. It’s a topic that frustrates me, and I wish that people would see the bigger picture.

    Thought I’d better add this, as in hind-sight it does look rather condescending!

  • Matijs Nijland

    Why We Should be Sending Some Psychiatrists and
    Some Individuals at Drug Companies to Jail

    The World
    Health Report 2001 explains that one in four people suffer from a mental illness.
    That means that mental illness is effecting hundreds of millions of individuals
    around the Globe. If you’re a business – providing therapy to individuals
    inflicted – does not make a very interesting business model because – of the high
    staff costs involved – and because such a model would mean a lot of
    competition. A medicine based approach – does provide a scalable business
    model.

    It is of no
    surprise – that this is exactly the strategy – that big business has chosen.
    For almost all mental illness – there is a medicine based approach.

    I am a
    psychosis sufferer and the side effects of this medicine based approach has
    been detrimental to my well being. In the past psychosis sufferers have
    received heroine, opium and cocaine for example. These solutions were all
    introduced by drug companies – as the best solution for society. Today there
    are anti-psychotics. The side-effects are really nasty of these drugs.
    Furthermore, a scientifically proven method called: Open Dialogue – from Finland
    has been around for more than 20 years. However, this understanding – is being
    purposefully kept – from other psychiatrists, policy makers and patients.
    Because, it is a therapy based approach – that does not provide an interesting business
    model. Now, this understanding is slowly spreading.

    With
    depression it is no different. The World Health Organization estimates that
    worldwide there are 350 million depression sufferers (Fact Sheet April 2016).
    The answer – from drug companies is coming up with anti-depressants. From 1999
    to 2012 the percentage of Americans on antidepressants increased from 6.8% to
    13%, according to a report published this week by the Journal of the American
    Medical Association (JAMA). Also anti-depressants can have detrimental
    side-effects. However, it is becoming more and more apparent – that alternative
    treatments – are similarly effective – without medication. Several studies show
    that psychotherapy (particularly cognitive therapy, behavioral activation, and
    interpersonal therapy) compares favorably with medication in the short-term,
    even when the depression is severe, and appears superior to medications over
    the long term (Antonuccio 2002). Again, this does not make a great business
    model for drug companies.

    Drug
    companies – especially their marketing department – have come up with
    strategies – to make drug use more prevalent and combat – increased understanding
    – that effectively – do not involve side effects from drugs. As an example – at
    psychiatric wards around the world – psychiatrists are stimulated – not to take
    the what they call incomprehensible communication of psychosis sufferers
    seriously – although it has been proven – Open Dialogue – that by doing so
    psychotic levels are lowered. Thus, more medication is necessary – and medication
    becomes the only alternative from coming out of a black hole.

    Academics
    around the globe have been hired by drug companies for their strategies.
    Governments have been tricked – or bought. Mental hospitals – chose strategies –
    to keep patients ill – since the science is now out there – so they are also to
    blame.

    I think it
    is time we start sending a lot of these crooks to jail for crimes against
    humanity. Especially – because – only now it is being more and more scientifically
    proven that love, understanding and healthy choices – in almost all cases
    solves mental illness. Has this understanding been around, since the beginning
    of time and has there been a lot of scientific misleading of humanity! I know
    the latter – but I can’t scientifically prove it!

    Matijs A. Nijland MSc