On July 15, I wrote a post called Psychiatry Debunks the ‘Myths.’ In that article I focused on the myth-debunking of Cognitive Psychiatry of Chapel Hill, but in researching the topic for that post, I came across a psychiatry resident named Shan (no last name) who blogs on a website called Exploratory Encephalotomy.
With regards to the name of the website, Dr. Shan explains on his About the blog page:
“…’exploratory encephalotomy’ implies opening up somebody’s brain in order to search for something. To the best of my knowledge, it’s not a real medical procedure yet…”
On February 13, 2013, Dr. Shan posted an article titled 6 common misconceptions about psychiatry. Here are four of his six myth debunkings interspersed with my comments.
“Myth: Psychiatrists treat and counsel people regarding their emotional problems
Psychiatrists are medical doctors who diagnose and treat medical illnesses that affect the brain and the mind. These illnesses can often cause emotional problems (just like any other medical illness can cause emotional problems), but the psychiatrist’s role is to treat the illness, not to tell the patient how to deal with life concerns. In fact, most psychiatrists try to avoid providing counseling, except as it relates to a patient’s medical therapy.
Psychologists and counselors, by contrast, may counsel people regarding emotional problems. These professionals, however, are not medically trained, so they do not treat medical illnesses.”
Not much ambiguity there. Standard bio-bio-bio-psychiatry.
“Myth: Psychiatrists talk to a patient about their deeper conflicts while they lie on a couch and face the other direction
This process, known as psychodynamic psychotherapy, was invented by Sigmund Freud in the 1800′s. Freud is famous because he was the first psychiatrist; however, his methods have very little evidence-based support. In the modern age of evidence-based medicine, this approach has fallen out of favor. In the middle of the 20th century, a group of scientists at Washington University in St. Louis started a charge towards an increase in evidence-based practice in psychiatry. Since then, the psychiatry world has developed objective diagnostic systems and advanced treatment methods that involve pharmacological therapy as well as surgical/procedural therapy.”
The inaccuracies about Dr. Freud we can let go. But in other regards, Dr. Shan is telling it like he’s been told: “objective” diagnostic systems; “advanced” treatment methods including drugs, surgery (lobotomies?) and procedures (electric shocks?).
“Myth: Psychiatric illnesses are caused by emotional conflicts
There was a time when it was widely believed that psychiatric illnesses are emotional in nature. Modern advances in genetics have helped to disprove this notion. We now know that a predisposition towards mental illness is largely influenced by your genetic makeup. This can be exacerbated by mental stress, much like in most medical illnesses – for instance, if you have a strong family history of diabetes, you can prevent/delay the onset of the disease by eating well and exercising a lot, but that doesn’t change the fact that it’s a biological disease with biological consequences.”
There it is – “psychiatric illnesses” are real illnesses – just like diabetes: biological diseases with biological consequences.
“Myth: Psychiatrists only treat crazy people
This is false in the same way that the statement ‘cardiologists only treat failing hearts’ is false. Most psychiatric patients have a genuine illness that is caused by a defective balance between different compounds in their brains (much like diabetes with insulin and sugar). When that balance is corrected, they are no longer ill. The illness may manifest as depression, anxiety, or a variety of other features that can make a person feel “sick,” but wont’ make them act ‘crazy.’
Other illnesses, such as mania and schizophrenia, may affect a person’s ability to function within societal norms, but we can usually treat them and allow the person to go back to their previous level of functioning. This is a big change from the days of big “mental asylums” and the like – instead of hiding people who are just ‘crazy,’ we can now treat people who are ‘sick’ and allow them to go back to real life. As a result of that, words like ‘crazy’ have become antiquated.”
Here we see clearly articulated the chemical imbalance theory, which the eminent psychiatrist Ronald Pies, MD, assures us that no well-informed psychiatrists ever promoted. And we even have the assurance that when the balance is “corrected” – “they are no longer ill.” (Corrected, presumably, by the drugs, the surgeries, and the other unspecified procedures.)
Obviously Dr. Shan has completely accepted, presumably from his med school teachers, the medical model of human distress.
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To me, and I imagine to most of us on this side of the debate, the logical and evidentiary shortcomings of psychiatry are glaringly obvious. I have often wondered how it is that people with sufficient intelligence to complete a medical degree not only don’t see through the fraud and the travesty, but actually embrace it with apparent fervor and dedication.
I realize, of course, that once a psychiatrist has been practicing for a number of years, the need to make a living can effectively eclipse any reservations he or she may have on the subject. But it’s harder to understand why people, nearing the end of their medical training, who presumably have a wide range of choices, would set their sights on the only medical specialty that invents, rather than discovers, the “illnesses” that it treats.
Dr. Shan’s website provides, I think, some insights into this matter. Here are some quotes. The first is from the About page linked above.
“Soon after I started medical school, I found myself stuffing my mind into the proverbial box that I so detested in the past. I surprised even myself at how quickly I’d acquiesced to the stringent rules of the medical field as they attempted to execute a subtle Machiavellian attack on my hopes to continue my young writing career. Before long, I started to notice the gradual corrosion of the unique outlook that I’ve developed thanks to my scientific training combined with my interest in the social sciences and the amalgam of cultural settings around which I was reared. This outlook was slowly being replaced by the guidelines of your favorite local medical board; in an attempt to ensure quality healthcare, those guidelines find a way to become ingrained into the medical student’s mind while extinguishing any iota of creativity and independent thought.”
And from a post Re-introduction, dated August 2012:
“I was soon to find out that medicine is not just a subject to study or a set of ideas to learn. It is an entire frame of mind to which a student must adhere.”
“At first, I felt like a robot, relying entirely on the memory centers in my brain while completely disregarding any remaining smidgen of independent thought. As optimistic as I may have been about the ultimate destination, it seemed like the journey asked for my humanity as a toll. I began to come to terms with the idea that in order to be a Doctor, I must first cease to be a human. I had to think in flowcharts, not ideas.”
“After a few years in medical training, I’ve finally started to understand where that outlook comes from: in the process of learning medicine, it is strikingly difficult not to let one’s mind turn into a hard drive. It happened to me after a while too.”
In other words, if I’m reading Dr. Shan correctly, in order to become a physician, one has to switch off one’s own critical thinking ability, and accept the tablets of stone as handed down by the lecturers and professors. This model may have some merit in the teaching of anatomy, physiology, etc., and even in the specialties like nephrology, cardiology, etc… After all, there is a great deal of factual material to be learned, and a pedagogical approach is probably economical and effective.
But it is disastrous as a method of preparing people for a career in the alleviation of distress, despondency, painful memories, feelings of inadequacy, etc…
Whatever initial thoughts or orientations trainees might have, in order to become qualified in, and practice, psychiatry, they must internalize the illness mantra, the spuriousness of which is evident to anyone with an ounce of critical thinking. They must dish out the pills. And they must never question or challenge the orthodoxy. They must never say that the Emperor has no clothes, because once that admission is made, the whole charade comes tumbling down.
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Psychiatry doesn’t just damage its victims. It takes its toll on the practitioners also. A human being cannot internalize this nonsense and inflict it on his/her fellow travelers day in and day out for years on end, without doing profound violence to his/her own humanity.