What are your views on psychiatry?

In My Humble Opinion
21

ca-nam, I appreciate your frustration with what’s currently available in terms of psychiatry or clinical psychology. As monstro says, those fields have a very tough row to hoe. The brain, and human behavior (and the interrelationships between those two) are exceedingly complex. We have made great strides, but obviously we have a long way to go before those disciplines are going to be helpful to everyone.

One thing to keep in mind is that psychiatrists and psychologists tend to be very careful about what they write, and so it pays to be very careful about reading what they write. Typically, they will not overtly cast judgment on something like drinking or drug use, but will, instead, point out the correlations that are available for all to see within the statistical data. It may look like judgment at first blush, but, really, most professionals in the field have experienced too much raw humanity to be so dense as to personally promote any kind of puritanical agenda.

As to the idea that it’s a fraud: you’re not too far off. I must point out, however, that both psychiatry and clinical psychology have a great number of very intelligent people working with the best science currently available and are very earnest in trying to understand and treat various conditions. Further, almost all of them will recognize (and some will even admit) that they do not have a perfect understanding. However, there are numerous studies showing the importance of therapeutic rapport and (I forget the jargon) presenting an expert “facade”.

This leads to a conflict that’s often talked about in such circles: professional therapists wish to come across as authentic, but also recognize that for many of their patients, what is most helpful is that the therapist seems to be understanding, expert, and in control. Given the fact that we are often blindly groping in the dark about many issues, it is very, very difficult for an individual to be both authentic (honest, truthful) AND come across as being expert and in control.

So, even the very best of therapists, with the very best of intentions, can often fall far short of being able to provide what we wish they could. And, given that there are some assholes out there in every field, and given that nothing ever lives up to its advertising, well, we are often in a position where it can be really hard to find someone, even a professional, who knows how to actually help us when we need it.

I often feel envious of those people who have had great success with therapy (psychiatric or psychological), and who recommend it wholeheartedly. As for my situation, I’ve had to do most of the heavy lifting myself, because I never did get lucky with finding a good therapist for me (well, I did once, but he was kind of an asshole, despite his talents). Anyway, my great hope is that in the near future, we will gain a great deal more understanding of how the brain works, and treating mental health will be much more like treating physical health. In the meantime, we can only work with what we have.

22

Insufficient data. The techniques used are open to question, and the failure rate is very high. I think more research is needed.

23

I was told directly by a therapist that 1/3 of the patients get better, 1/3 get worse and 1/3 stay the same. This was for “talk therapy” not involving drugs or pharmaceuticals

To me, thats not a very strong correlation to support the efficacy of the technique. I’ve been to a few sessions at various points in my life for family matters. For my experience, they were impartial listeners that talked to you like a good experienced grandfather, bar tender or friend. If you lack those resources it might be useful. But for me, I didn’t get a great deal out of it that I could have worked through without them. I think the key advantage is that they are impartial; something that you may not get with a listening friend/relative.

Would I go again? Maybe…does insurance pay for it? Sure. With insurance the cost/benefit was worth it.

24

I believe that we have a better chance of understanding the programming process that our brains use than we do of understanding a programmed brain. Techniques for brainwashing and reprogramming seem to be fairly well understould by con artists, preachers, jigalos and other less scrupulous individuals we run across in our daily lives.

Many lives have been turned around by twists of fate that have exposed people to a sets of circumstances that supplied them with something they were missing. Our brains interpet all the input they are exposed to based on reactions we get.

I would like to see an experiment with roll playing. Say we have 100 actors in a small town setting, maybe more. We either choose or assigned a character to play and everyday show up for a couple of hours or so and be this character. Using a format like this someone could experiment with different characters. I think it would be interesting.

25

Truth. This isn’t like tinkering with a motorcycle engine. It’s maybe a little more like tinkering with a large and complicated ecosystem, where all the parts interact with all the other parts. When something goes wrong, it is simply not known, today, how to fix it…and any fix is likely to be very complex.

Progress is being made. We’re better off today than we were fifty years ago. Sometimes, that’s all we get.

26

Not only that, but the (very short) article at the link link does not say either of the things that the OP says it does (nor even anything that could plausibly be misunderstood to be saying them). I can only conclude that ca-nam is not someone who can be trusted with regard to fact, and not someone whose opinions deserve any serious consideration.

27

In my experience with people I know being treated for it, psychopharmacology’s results for bipolar disorder are nothing short of miraculous.

28

The answer is messy and complicated. It’s not a bad oversimplification to say “it’s a fraud”, but some additional elaboration and specification is probably useful.

First, a disclaimer: I’m a participant in the psychiatric patients-rights movement so I’m a partisan and don’t claim to be impartial.
Historical Backdrop: Once upon a time (around 150 years ago) there was optimism that the phenomenon of being crazy would yield up the secrets of its causation and cure to modern science, which was doing having those kinds of results in other fields of inquiry. The notion that craziness was essentially medical led to the concepts and phrases “mentally ill” and “mental illness” and so forth. These “mental illnesses” were identified according to recognizable patterns of observable symptoms.

Lo and behold, several of them DID INDEED come to be understood in that sense. One of the mental illnesses became understood as what we now call epilepsy; another became known to us as tertiary-stage syphilis. Well, now that we understood the etiology of these specific mental illnesses, there were more than one type of doctor who could lay claim to being the appropriate doctor to send someone to: the internal medicine doctor to treat syphilis, or the psychiatrist?

Generally speaking, psychiatry had a dismal reputation, dark dungeons and hopelessness and screaming patients on locked wards and all that, so given any choice in the matter, people went to the internal medicine doctor or the neurologist or any doctor other than a psychiatrist, as a consequence of which those diseases were effectively taken away from the subfield of psychiatry.

Psychiatry, by the middle 20th century, was left with the ones that had never yeilded themselves up to scientific inquiry.

The Chemical Imbalance and the Hegemony of Pharmacological Psychiatry: It started with Thorazine (chlorpromazine). It wasn’t originally developed from an initial understanding of a mental illness; instead, people looked at the chemical and wondered what it could be usefully deployed as. It was harshly unpleasant as an antihistamine — turned you into far more of a zombie than existing antihistamines — but that side effect made it look like a useful tool for tranquilizing upset people. It found a home on mental wards.

The field of psychiatry still had a nasty reputation as a pseudo-medical pseudo-scientific profession, still associated with dark dungeons and locked wards and all that, and its practitioners sought the mantle of rational modern medicine. As other chemicals found uses w/regards to treating the various mental illness, the hypothesis was formulated: that the medications in question were not merely ameliorating symptoms and making crazy people easier to control, but were actually replacing missing chemicals in their brains or otherwise fixing “chemical imbalances” that were the root causes of these poor folks’ suffering: either they lacked some neurotransmitters or they had too many or they were undersensitized to their own neurotransmitters or oversensitized to them, or they had too efficient “reuptake” chemicals that were absorbing and dampening them too much, or too few and not enough. And to flesh out this hypothesis, the researchers looked at what the chemicals themselves were doing in the brain. Some of the psychiatric medications intervened in dopamine chemistry; some modified the brain’s use of serotonin; and so forth.

It was touted as a solidly proven scientific fact: mental illnesses are caused by chemical imbalances and we, the psychiatric profession, have the correct cures for that right here. And, as you can see, the pharmacology industry sort of had reason to like that narrative also. Problem was, the evidence never supported these hypotheses. People with the designated diagnoses did not in fact have the expected deficits or surpluses or insensitivities or excessive uptakes or anything that make the psych meds realistically a replacement or fix. Chemical imbalance is not a fact. It’s an hypotheses not supported by research.
Modern psychiatry nevertheless is highly regarded by many people who have had good results turning to it, people who have found the medications useful even if they are not what is claimed for them by the psychiatric profession.

29

I think various therapies are sets of tools. Sometimes, those tools may be the right thing for the job. Sometimes, they aren’t. Like any too, though, it’s not just going to passively do the job for you. You have to take an active role in applying it.

30

Finding the right therapist can take a while. My first foray into therapy in my early 20s, I realized that on the drive to the appointment I was rephrasing what I would say, because I could imagine her response and I didn’t want to hear those comments. Then it dawned on me that what I was trying to mask was exactly what I should be talking about, and was able to get deeper into the real problem. What a revelation! Some therapists, though, I believe some are in serious need of therapy themselves. Some have an agenda and diagnose what they want to work on. I worked in a psychologist’s office for awhile, and was able to see how different their approaches are, with some being true healers, some just making money, and some appearing to be in it for the power and ego. The wrong ones can just be a waste of time and money, but the right one can work wonders and change your life.

31

There are some life problems that people have that could be resolved very simply. (Note I use the word simply and not easily.) Not all things that people seek out psychiatric help for are this way but a great many of them are.

You could make a list of behaviors that need changing in the order they need to be changed and an explanation of how to do that and if the client would follow the list to the letter, like a prescription, he could alleviate himself of these kinds of interpersonal issues, addictions or other dangerous or problematic habits.

But people often will refuse to do it. The truth is that many of the things that plague us have hidden rewards that we are unwilling to surrender.

Willingness to surrender to the process is probably one of the largest obstacles to effective therapy there is. But certainly not all of the reason for dissatisfaction.

32

I would know if she was the right therapist for me, considering that I am me. Not every technique can be applied to every person. I’m not speaking about mental health professionals in general or even this style of counseling in general, but simple stating that I relate to the OP in saying that it isn’t beneficial to me. It’s something that I can and would do on my own.

33

But that’s the thing. What works for some–or even most–won’t always work for one. Frankly, I wouldn’t want to work with a psychotherapist who provided no advice or feedback and just served as a “blank slate”. But enough people prefer this approach that’s still widely practiced.

34

Here are a few things to consider.

A person with psychological/emotional problems doesn’t have the same luxury of being able to get irate at small things as a supposedly healthy one does. When he goes off on something usually more damage is done in his life.

It’s not uncommon for people who don’t know what their issue is to self-treat with alcohol to keep themselves feeling calm or to avoid thinking about disturbing things. Addiction can develop if his mental state persistently needs soothing. And the alcohol will also interfere with his ability to accurately discern his reality.

So this advice is less about morality and more about maintaining good health. Actually, now that I think of it, a lot of seemingly moral messages are about maintaining good health. And it’s in society’s best interest to promote health.

35

I think anyone who goes to a psychiatrist should have his head examined.

36

Therapy is tough. When I was a teenage, I had one that I loved but our insurance dropped him, and I never saw him again. Throughout the years i’ve seen maybe a dozen since then, still haven’t found one that I really click with. It doesn’t mean that they aren’t good at what they do, just doesn’t work with me I guess.

As for the medicine part of it, some doctors are better than others, just as in regular non-mental medicine.

37

I agree that not every technique works for everyone, I just disagreed with your “needless to say”. I interpreted it as meaning that the technique you referenced was clearly ineffectual and wouldn’t work for anyone. If you meant that you were aware that it wouldn’t work for you, then that makes sense and I apologize for reading it differently.

38

If you’re interested in changing who you are, to be happier, more successful, less anxious, whatever, counselors and doctors may ge able to help you. If you are not interested in changing who you are, but want everything to be all better, seeking treatment will be frustrating and pointless.

Doctors treat the sick. It’s worth pointing out that many people are not compliant with physical treatments. They don’t go, or they skip meds, or they lie, even to their own detriment. People mistrust. Add in…

It’s hard to see yourself as the problem when you have a mental illness. And if you can’t admit “there is something wrong in my life that I cannot fix” then what do you expect? You’re not going to listen to anyone who tells you otherwise, family or scientist.

39

I am not a Scientologist so I think psychiatry is a real science that helps people

40

What AHunter3 said, plus some more history that might be helpful.

You’ve probably heard of Freud. The father of psychoanalysis. Monstrously influential, died in 1939–not all that long ago in the scheme of things.

Freud and his followers thought that mental illness was caused by stuff that happened to you. They literally believed that bad parenting, etc., caused schizophrenia, etc. Further, they believed that talking through stuff–analysis–could cure mental illness. This view of the mind held sway more or less until the 1970s.

Meanwhile, during the 20th century, drugs, shock therapy, lobotomies (!), and other physical means of treating mental illness were devised. (They had existed before, such as the water cure for “madness,” etc., but this time the innovations were occurring in the context of Freudian thought, which was thought of as rock-solid science.)

Keep in mind that psychiatrists were MDs, graduates of medical school, who could prescribe drugs like any other doctor. So during the 20th century into the 70s, you had psychiatrists (MDs) taking Freudian psychology seriously while also treating mental illness with drugs (though docs could have different approaches, and of course it was all changing as time went on).

Here’s the important thing: Rightly or wrongly (probably more rightly, but not all in my opinion), Freudian psychology was ditched in 1970s onward. Today, it’s not treated seriously by psychiatrists at all. In fact, psychiatry today barely treats people as though mental problems can be solved by mental processes at all. They just use drugs. Psychiatrists don’t perform “analysis” or try to counsel you. They may take a history, but then they give you meds. Meds don’t work? They try other meds.

Meanwhile, “therapy” has evolved along a different route. The core belief of “therapy” is that changing your mental content can change your mental state over the long term. Therapists are not MDs and can’t prescribe drugs.

Some therapists are still old school Freudians. They can be anything and everything. Most of the time, however, such therapy is not called “psychiatry.” Today, that is pretty much synonymous with prescribing meds.

So… psychiatry and therapy have this disjointed, messy history. A major paradigm has been thrown out in living, even recent, memory. And as a person who believes in the spiritual side of people, I both therapy and psychiatry tend to miss big chunks of the picture (Freud was very much an atheist, and psychologists and psychiatrists tend still today to be atheistic in their approach. Ironically, I think one reason Freudianism was completely tossed out was that, although he was an atheist, his view of mental processes and their deep roots and meanings still seemed like a spiritual paradigm.)

So is psychiatry a fraud? I don’t think so, but its foundation as an all-drug mode of treatment is pretty recent and pretty shallow, in my view. In some ways, I think a cultural bait and switch has been pulled: people came to expect “analysis,” in which their lives and origins and problems were treated as important, and then suddenly, nope! Just drugs. All drugs. Then again, analysis was probably ineffective in treating the vast majority of problems, anyway.

So is therapy a fraud? I think a lot of it doesn’t work, and there are sadly a lot of people on which nothing is going to work. But it’s just human nature for us to pretend that we have the ability to take care of problems with our current toolbox. This is exemplified by the advice, whether said sarcastically or sincerely, to “seek professional help.” The naive belief being that there’s a treatment for everything. There isn’t.