Is this video exploitative?

I’m putting together an important talk and I need something that shows the symptoms of schizophrenia. I found the following on YouTube: link (perfectly SFW). I like it because it quickly shows that it’s legit (from the NIMH) and gets right into the patient interview.

However, my wife, who is a medical doc, questions whether it’s ethical to show this to a public audience. She wonders whether it’s effectively exploiting the patient because it clearly shows his appearance and he wasn’t capable of consenting to having this film distributed, putting him at risk for discrimination.

I think she has a valid point, but I’m undecided about how I feel. I should add that we just found this video being offered as part of a set of commercially-available set of psychological teaching DVDs (link), which makes us feel better, I guess.

Anyway, is it a bad idea for me to use this in an important talk? I think it’s very compelling and would work well in the talk, but ethical violations are obviously not a good thing when trying to impress people…


Things you, and your audience, should be made aware of:
a) The funny “ticcy” repetitive motions of his legs and hands are not symptoms of schizophrenia; they are symptoms of Haloperidol and other neuroleptic psych meds he’s been kept on long enough to cause a form of permanent brain damage called tardive dyskenesia.

b) Patient’s statement that “I feel as though people have called me here to electrocute me, judge me, put me in jail” is not a symptom of being grossly delusional and/or thought disordered. It’s a perfectly rational, damned reasonable and fundamentally accurate assessment of reality. Or at least such is the case UNLESS you consider it grossly delusional for someone to hold that impression after being held in a locked setting subsequent to being ‘judged’ dangerous or in need of psychiatric treatment and then being subjected to a series of involuntary electroconvulsive treatment (electoshock), both of which are likely to be true in his case, or if not, true in the case of people incarcerated in the same place or places where he has been held in the past.

c) Patient’s recommendation that “the main thing is to not get excited” is pretty sound advice to anyone being held in a psychiatric facility. “I am scared of people” also makes sense in this context.

d) I do have disagreements with patient’s explanation of how sperm and egg fuse, and did not find his analogy to interactions on a subatomic level to be useful or convincing in any way, but I am not sure that having unclear or incorrect concepts of biological processes or drawing clumsy analogies is a symptom of much of anything.
I don’t find the video in and of itself to be exploitative of the patient, but a lot would depend on how you intend on using it. I’d be inclined to use it as an example of how a normal rational person, once labeled “schizophrenic”, is seen almost exclusively through the lens of that dx by psych professionals.

Well, it’s an interesting perspective and one I’m generally sympathetic to (this same idea really bugged me during my psych rotation in med school). But I think you overstate your case; for example, the purposeful hand movements are much more representative of compulsive disorder than of TD, which tend to be more single motor groups and not purposeful. And if you really think this guy is a totally rational person, well…you’d be in the minority.

I sure wouldn’t attribute any of his movements to things other than drug side-effects. In addition to TD (which could explain it all in and of itself, IMHO), psychmeds cause restlessness and a certain & recognizable kind of awkward stiffness.

I should not have declared this person to be a totally rational person. I would say it would be humane to assume anyone to be a totally rational person except where compelling evidence indicates otherwise; there may be plenty of that for this dude, but I was struck with how the voice-over begins asserting such at a time in the video where we’ve seen no such evidence.

The trauma of being treated (in all senses of the word) as a psychiatric patient needs also to be kept in mind. If you take 10 randomly selected folks, declare them to be schizzies, drug them up with Stelazie Thorazine Haldom and Prolixin for a few years, put them on a locked ward with the usual denizens thereof, under the control of typical ward staff and doctors and under the social regimen of the culture and rules governing same, figure that to be your hypothetical control group to which you would be comparing this person when assessing for irrational delusional etc behaviors and thought processes and disordered / inappropriate affect etc etc. Comparing this person’s behavior to the behavior of the 10 folks as they were before our thought-experiment would be inappropriate on OUR part.

As I said before, I’m generally sympathetic to your point of view. However, we need to be aware that, just as the ‘pro-psychiatry’ perspective colors the view of a person’s behavior, our ‘anti-psychiatry’ perspective can do the same.

You argue that what we’re looking at here is a (mostly) normal guy viewed through the lens of the psychiatric establishment. But his thinking and behavior are objectively disordered to the point of being disabling. You argue that this is because of drugs + years of treatment. But why was treatment begun on him in the first place? I think you venture into consipracy-theory territory if you believe that the psych establishment would force a perfectly able man into treatment for schizophrenia. Psychiatrists may be misguided in equating ‘abnormal’ with ‘disordered’, but they genuinely have the best interests of the patient at heart (most of them anyway). If he was not complaining of his symptoms and he was not a danger to himself or others, no psychiatrist with any decency would lock him up.

Anyway, this is becoming more of a GD discussion, and one that would be very interesting to me (along the lines of ‘Is the concept of psychiatric disease false and unjust?’). But I know for a fact that the psych establishment isn’t as nefarious as you suggest.

I didn’t watch the youtube clip, but I remember being shown a video of this fellow in an introductory abnormal psych course. I can’t really offer any answers about whether it’s exploitative, but I can tell you that it was probably the most fascinating and memorable video on the topic of psychological disorders that I’ve ever seen. His body language is strange enough, but the continuous stream of bizarre ideas that he produces, with no organization or logical basis, is just incredible.

Are you sure he didn’t give consent to appear in the commercial videos at a later time when his thinking was more rational?

Wow! Bad Astronaut! Welcome back, dude! Have you been around and I simply haven’t noticed?

Hmmm, I’ve been reading the SDMB for a long time, but I didn’t register this username until recently, when it became free to post. Maybe there was someone else with a similar name in the past?

He may be thinking of The Bad Astronomer.

Yes, I was. :smack: