Dave's Progress. Chapter 12: Some Passing (Paranoid?) Thoughts on Psychiatry.

I don't know about you, but I've always had a vague mistrust of psychiatrists. For one, just simply the fact that they, along with GPs and social workers, have the power to put you involuntarily into hospital, I find a little scary. All that authority. To potentially have the ability to curb some one's liberty without their consent. I don't know whether I'd want such a big responsibility myself. And it wouldn't be so bad if they didn't get things wrong seemingly much of the time. I only have to look at my own history of mental distress to understand that psychiatry can often be a game of hit and miss. I believe this is largely because the view point of the psychiatrist is subjective and largely unscientific. It is, for the most part, sheer guess work. So when a psychiatrist tells you that he or she is scientific and objective in his approach, don't believe him or her. At this point, he or she will probably tell you that you're exhibiting signs of paranoia.
And, it would seem, therein lies much of the problem. The tendency of the psychiatrist to medicalise what could be just "normal" behaviour. It seems that psychiatry has such a narrow view of what is normal and what is not that sometimes personality is mistaken for pathology.
Indeed, this point seemed to have been proved in the 1970's when an American psychiatrist (his name eludes me now) and his mates, all being perfectly sane, attempted to get themselves admitted to psychiatric hospital. Without exception, they were all admitted and all thought to have some form of mental disorder. It took some at least two months to get themselves released. I suppose you can just imagine it- "Doctor, you don't understand, I'm perfectly sane and part of an experiment to prove that actually you are the insane ones." To which the doctor replies to his colleagues- "OK guys, we have a real fruitcake here. Seems to think he's part of an experiment to prove that we're actually the ones in need of help. Give him 20mg of Olanzapine and tell me when he wakes up."
As if this weren't enough, some of the observations which were made of these patients seem bizarre. As one of them wrote a diary, for example, he was said to have "obsessive writing tendencies". I wonder what they'd say about me and my recent blog addiction ( which seems to be fading, by the way. Honest, doc! )
The resulting article from this experiment, called "Being Sane in Insane Places", sent shock waves through the psychiatric world. It also seemed to prove or justify the opinions of another famous psychiatrist, Thomas Sasz. Sasz had suggested that psychiatry, in the wrong hands, could be used as a form of social control by "medicalising" people whom society simply found difficult to cope with. Indeed, if one looks in the DSM V, the American psychiatric diagnostic manual, you will find such diagnoses as "conduct disorder", a couple of the symptoms of which are aggressive behaviour and being loath to comply. It is easy to see from this where Sasz was coming from. What could be simple growing pains or put down to social and environmental factors was "medicalised" into a form of disease. Sasz also complained that psychiatry was resolutely unscientific, saying that when medical doctors wanted to prove a disease they looked to pathologists, when psychiatrists did so they looked to lawyers. All this adding to the notion that psychiatry was in fact based on the subjective opinions of a relatively small number of people of what was "normal" and what was not.
So, am I being paranoid in my slight distrust of psychiatrists? Or is the basis of my judgement in fact. No doubt you have your own (subjective) opinion. That's all for now from your normal, average, paranoid (not this time!) and delusional man.


dcrelief said…
Very nice post David; no argument here. Take care, dcrelief
Phathomicus said…
What's the worse that could happen if I were hospitalized? I would miss a cup of tea at home! For one to believe that others are talking, laughing, or otherwise concerned with their purchases at the supermarket is paranoid; most would not be surprised to learn it was not s/he being spoken of. Pdocs have the responsibility for those that due to incapacity, have a lack of objectivity. By the way there is no "normal" in society!
David said…
Firstly, thanks dcrelief. I almost wish you were more argumentative! I shall be back to comment on your blog soon.
And to phathomicus- thanks for your comment, although I am bound to disagree. Anyone who says that all they would miss if hospitalized would be a cup of tea at home has never spent time on an acute ward of a psychiatric hospital. Wards can sometimes be threatening and violent environments and it's not only me who thinks so. A recent report in The Observer newspaper said that wards in London inparticular were witnessing increasing incidences of violence, sexual misconduct, drug taking and alcohol abuse, making them a a far cry from being the "therapeutic" environments that it is their remit to be. If a ward is deemed not to be therapeutic, it loses its purpose completely.I do speak from experience here, having been on an acute ward many times throughout my own experience of mental ill health.
Also, I do know what "real" paranoia is, having suffered from the delusional variety of it myself. Again, I know whereof I speak. And I would agree that psychiatrists have a responsibility to those who are incapacitated due to their illnesses. I was simply arguing that some aspects of psychiatry can appear somewhat authoritarian. Perhaps you are not familiar with mental health law in the UK.
Finally, I agree that there is no such thing as "normal" in society. Here you seem to have completely misunderstood my argument. What I was saying was that it is psychiatry that has a narrow view of what is so-called "normal" or "sane" and what is not, and that by having this view it can (sometimes) mistake personality and psychopathology and is based (largely) on subjective, not objective or scientific,ponts of view.
Anyway, thanks for visiting my blog. Hope you return to read this comment.

Yours with Best Wishes,
Phathomicus said…
I also speak from experience as a bipolar. I was not medication compliant at first because, I had argued with doctors that they change my personality! To quote someone from my home city - The desire to take medicine is perhaps the greatest feature which distinguishes man from animals. - Sir William Osler
David said…
Thanks phathomicus for answering my comment. Just glad really that someone else has taken an interest in my blog. Please feel free to drop in anytime and tell me if you think I'm talking crap!

klahanie said…
Greetings David,

In my case it's not so much about a mistrust issue. What I do have a problem is when I'm told how to react to situations in my life.
When I was hospitalised and traumatised, generally speaking, I felt the 'professional' staff at the psychiatric unit were more inclined to undermine my issues and talked down to me. They made me feel like a 'naughty boy' and they knew better. Hardly condusive for someone attempting to recover from mental health issues.
What I learnt is that, I am the expert on myself. Others can encourage via 'reflective' interaction. Yet, instead of using 'echoing' methods and verbalising what they thought I meant, they proceeded to tell me what was best. Very bizarre.
Thanks for this blog David. Ofcourse, I suppose what I just typed was crap. But hey it's my crap. Warm regards klahanie aka Gary.

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