What are your views on psychiatry?

In My Humble Opinion
61

Bad feelings can sometimes be caused by bad behavior. In spaghettifier’s case the therapist suggested some new behavior to help change spaghettifier’s thoughts.

You can be anxious because you were abused as a child, or you can be anxious because you always cheat on your wife. In the latter case, I don’t think the cheater will feel better about himself unless he changes his behavior. Nor do I think he should feel good about himself unless he changes his behavior.

I think you’re assuming Spaghettifier knows what’s best for himself, and I’m assuming he doesn’t. It’s possible that Spaghettifier is dealing with a problem so stigmatizing that he can’t find anyone to validate his feelings regarding the problem. And that once he sits for several sessions with a therapist who validates his feelings that his problem will go away.

But we don’t know if that’s true. What we do know is that Spaghettifier went to one therapist who thought he needed use more CBT techniques, and Spaghettifrier thought this therapist was too judgmental. We don’t know the thoughts he was dealing with, or why he went to therapy.

It’s possible there is more to the story that Spaghettifrier is leaving out and that I"m dead wrong. But from what I’ve read it looks like Spaghettifrier is closing off all criticism of his behavior, which can prevent him from getting better in certain cases.

62

I think this goes without saying, Lakai. I don’t know why a person would need to have a therapist tell them to stop doing something that was so clearly wrong. I mean, most of us know when we are doing “bad” things. Child molesters and wife cheaters included. Why would anyone pay a guy/woman $200 an hour to hear “stop cheating on your wife, bro”? That’s not really insightful.

What might be helpful to the patient is to figure out why he cheats on his wife so much. “You mean to tell me I cheat because my father does and I’m trying to be like him? The man who used to call me a sissy all the time, who questioned whether I was even his son? And by cheating I’m letting him and everyone else know that I’m a real man? You mean to tell me there’s more to this than me just being a horndog who can’t help himself?” Sometimes knowing the “why” motivates people to stop their bad behavior.

Or maybe not. Supportive therapy isn’t about “curing” problems. Sometimes it’s about maintenance. For instance, let’s say you have every psychiatric condition in the book. ADD, schizophrenic, bipolar, OCD, and a couple of personality disorders. You’re all kinds of messed-up, but you’ve been stabilized for awhile. Don’t have a job or a social circle because you’re way too handicapped, but you aren’t a danger to yourself or to others. You’re just hanging in there as best you can. Is it realistic to expect a therapist to “advise” all your problems away? Or is it more realistic for that therapist to be there as a listening ear when the hallucinations get too loud, you believe the CIA is after you, or you’re just lonely and you don’t have anyone to talk to about anything, including daytime TV shows. Yes, the therapist should probably feel comfortable advising you on lifestyle and habits. But the “listening without judgment” part would probably be more important.

Exactly. So why are you assuming that you know better than he does?

You don’t know if his behavior needs criticism. Maybe it does, and he’s just not ready for it. Maybe when he’s ready, he’ll find a therapist who will give it to him straight. But at that particular moment in time, he just needed someone to hear him out and let him kvetch. There are plenty of people who will provide this service for him, so apparently some patients find it useful.

63

Sorry to butt in, but that’s bullshit. Anyone who molests a child automatically loses the right to be treated with sympathy. I hope you did the right thing and turned his ass over to the police, dr/pt confidentiality be damned.

64

That theory isn’t invalid, and needs to be brought back. A childhood full of abuse, neglect, invalidation, etc. will cause far higher rates of a long list of mental illnesses than a healthy childhood.

http://psychcentral.com/news/2006/06/13/child-abuse-can-cause-schizophrenia

65

I work with adults, so by the time I heard about this, they were all adults. State law requires that I report all child abuse I hear about (regardless of the age of the abuser) as long as the victim is still under the age of 18. In the case I mentioned, it happened 20 years ago, and everyone was over 18 by that point, so I can’t report it.

That said, this idea of “terrible people” bothers me. People do terrible things, but what does it mean to be a “terrible person”? Let’s flesh out my example. Imagine a 6 year old girl is sexually abused. The next day she does the same thing to her 5 year old sister. Does she lose the right to be treated with sympathy? She’s six, for heaven’s sake, and doesn’t understand what is going on. Is she a terrible person?

I don’t think mental health issues lend themselves well to black and white thinking.

66

I think monstro makes a good point when she talks about timing. Sometimes the message is a good one but the person receiving the message isn’t yet ready to understand it or use it.

This has happened to me a couple of different times in my life. I wouldn’t say that the counselor was off the beam, just giving me information that I wasn’t ready yet to incorporate. At a later date, when the time for understanding was right, it suddenly clicked and made sense.

67

I have never understood when or how someone would have made the decision to spell Psychiatry with a silent “P”.

Can anyone think of a possible scenario where this would have first come into being? I mean, what the Heck is that about? How would anyone ever decide to use a silent “P”? IMO, that is the single most ridiculous concept in the English language.

There are all kinds of letter that act as silent letters and don’t make a lot of sense. Like …

Silent “g” and “h” in “though”.
Silent “b” in “bomb”.
Silent “c” in “muscle”.
Silent “d” in “sandwich”.
Silent “n” in “hymn”.
Silent “t” in “wrestle”.
Silent “u” in “built”.
Silent “w” in “wrong”.

All of the above don’t seem to terribly off the beat. But a silent “P”? That is just too bizarre.

68

It’s all Greek to me…

69

Let’s all put the Pee back in psychiatry
Seems like something’s missing when you say “Sy,” you see.
It may be sorta zany
And it may be insane
But there’s a Pee in psychiatry, it’s plain.

70

Clearly wrong to who? Clearly you’ve never spoken to someone who was cheating on his wife.

You’re thinking the guy walks into therapy because he wants to stop cheating. That could happen. However, it’s also possible he walks into therapy because he cannot connect with his wife, feels lonely, drinks a lot. Maybe the answer is that he should stop cheating on women if he wants to feel connected.

No arguments here.

Again I agree that supportive therapy can be helpful. But it’s not always helpful.

I’m not. I’ve admitted that I don’t know the whole story and could be wrong.

And you don’t know if he needs supportive therapy. What we know is that a therapist told him to do something real simple and instead of trying it, he left therapy. That sounds like he’s not ready to do anything about whatever he came to therapy for.

71

If your therapist kept telling you to do something “real simple” and you knew you weren’t ready to do it (let’s say she kept telling you to stop overthinking things and go out on a date already), wouldn’t you quit too? Especially if you were only just a few sessions in? I know I would. Not all “simple” advice is useful advice. And sometimes you want your therapist to have all the necessary background before weighing in with any opinion, insightful or not.

I’m not making any assumptions about Spaghettifrier’s problems or what he’s willing/not willing to do. You are, though. I think this is why we’re looking at this differently. There are a ton of good reasons why someone would not care to hear advice. Until Spaghettifrier fills in the gaps in his story, I’m going to trust he knew he was doing and not judge him. I know this is how I would like someone to treat me .

72

You’re right that I’m assuming Spaghettifrier is wrong and his therapist was right until I get further details. It’s actually the lack of details in his story that’s preventing me from trusting his judgment. He’s not giving examples like you are of situations where simple advice would be unhelpful, he’s creating a hardline rule against all judgment.

I can only go by what he said in his post: “It is therapeutic for me just to be able to come in here and shamelessly tell another soul what I struggle with without feeling like I am being a burden, or being judged, or worrying that I will worry someone too much.”

That doesn’t sound like a thoughtful judgment because sometimes accepting judgment on your behavior is exactly what someone needs to get better.

Although I’ll admit it’s possible there is more to his story he didn’t feel like sharing and my critical post was too harsh because it didn’t account for that possibility. I should have just made a post about how judgment can be helpful at times, and not a post that mostly criticized Spaghettifrier.

73

Back to addressing the OP:

Although he does not call it a fraud, James Davies, a British psychotherapist who, in his book Cracked: The Unhappy Truth about Psychiatry, does take a critical look at the discipline.

He says the profession keeps adding new disorders to the Diagnostic and Statistical Manual, classifying as mental illnesses many things which are just part of the normal trials and tribulations of going through life. He points to studies which show that antidepressants are no more effective than placebos in treating depression. There is no evidence for a biological basis for many disorders that are nevertheless commonly treated by drugs. Above all he points out how the pharmaceutical industry pays for, cherry-picks, and reinterprets studies to show their drugs to best advantage. He also cites a real lack of transparency in the financial arrangements the industry has with doctors, especially those at the top of the profession who become strong advocates of the industry’s drugs.

Fraud might be too strong a word, but there are still a lot of questions to be answered.

74

If the problem is misinterpretation, but not made up data, shouldn’t professional psychiatrists be able to look at these studies and come up with their own conclusions?

75

If psychiatry didn’t work for you, maybe you’re just not crazy enough.

I’m not even that whacky and antidepressants and intensive cognitive behavior therapy in conjunction with not drinking and exercising regularly have very much helped me. However, I will say that I’ve had years of fruitless therapy and outright bad therapists before.

My mother is bipolar and I can tell you there is a massive difference between medicated mom and unmedicated mom. Yet I won’t deny that there’s tons of BS in the specialty. But it does serve a very real function for a lot of people and it is very slowly getting better. I tried a million drugs before we finally got a genetic test and a really good neurologist to figure out what would work for me.

76

A lot of good comments in this thread. I’m also a therapist, and one of the points I make to my clients is that nothing ‘works’ on you. Not therapy, not AA, not marriage counseling, etc, in the sense that in all of those settings it is up to the individual to work the tools provided. I see my job as knowing which tools (approach) will most likely be of benefit to my pt, if she works it.
Humans are complicated. My work is very interesting.
Terrible people don’t generally present for psychotherapy, and would be poor candidates for a number of reasons, anyway, so I don’t have much experience with them.

77

No, it isn’t. You can be told that what you are doing isn’t helping, but you should never be judged. No good therapist can work without sympathy. You must be able to first connect with your therapist before they can affect change. Someone who judges you sets themselves up to be your enemy and not your friend.

There’s a huge difference between trying to help someone get over a bad mental habit and judging them for having that bad mental habit. And the latter is clearly what the poster in question is talking about.

I can only think you don’t understand what it means to be able to share something without being judged. It definitely doesn’t mean I can’t think what you did was wrong and tell you that. It just means that I don’t think less of you because of it.

78

That’s rather Buddhist of you. :rolleyes:

No, seriously, learn to be mindful of your emotions and the fact they aren’t reality. And relearn how who you are and what you do are not the same thing. That’s stuff I picked up in two weeks of study, and I’m only dealing with mindfulness component.

79

[quote=“BigT, post:77, topic:677202”]

No, it isn’t. You can be told that what you are doing isn’t helping, but you should never be judged. No good therapist can work without sympathy. . .QUOTE]

If I may, I’d like to make a distinction between sympathy and empathy.

Sympathy implies that the therapist is having feelings for the client. It happens and when it does needs to be dealt with by establishing healthy boundaries. A therapist who continues to, for instance, feel sorry for her client is apt to slip into enabling behavior or perhaps have difficulty sleeping over the client’s problems. It can create a sort of parent/child relationship.

A more workable state of emotion would be empathy - that the therapist understands the client’s struggle and the feelings the client is having related to it. It helps to keep the relationship on a more equal level and allows the client the dignity of carrying their own feelings and solving their own problems.

80

I’d like to go ahead and make a few more comments about psychiatry and clinical psychology, from my perspective [I’m including those two disciplines based on my reading of the OP].

I’m a huge fan of science, and of science fiction. I’d call my self a futurist, except that label has a particular meaning, and, although I like the concept, I haven’t been invited to any meetings. Nevertheless, I often think about science in large, grand, broad swaths of history-type terms. What will we say about this particular subject in a century, or ten centuries?

From that perspective, psychiatry (and clincal psychology, to an extent) is fucking barbaric. A hundred years from now, we will have learned so much more about the brain and its behavior that our current history of the field will seem like fucking leeches and prayers. I mean, clinical studies for currently available medications do provide a more accurate profile than “eh, just bleed 'im”, but, frankly, not by much. So many of the mechanisms behind the disorders that are slotted for aren’t understood that we aren’t, philosophically, very far beyond bleeding the humors.

There are probably some professionals in the field on this board who would take umbrage to my depiction - and to them, I say, fuck you. Learn to read. In a century, you will be considered a barbarian, and if you aren’t aware of that, then you are lacking the most important insight of your career.

Because most psychiatrists, and clinical psychologists, are working with the best tools they have to offer. But our (societally) understanding of the functions of the brain is pretty primitive (from a historical perspective). Clinical therapists (almost universally) have an understanding of the complexity of the human psyche that is well beyond mine, due to their experience with others. But it is still far less that what future clinicians will have, once we have a better understanding of the brain and its functions.

Put most simply: current psychiatrists and clinical psychologists are doing the best they can with the tools they have. And those tools (empathy, clinical experience, research,etc) are fairly formidable. But they are limited by the fact that we simply don’t have the same understanding of the brain and consciousness as we do of germ theory and other medical concerns. Give us another century or two, and our treatment of mental health issues should improve greatly.

In the meantime, well, it’s up to you. Are suffering so badly that some random medication might be your best shot? Because some of us are indeed in that position. Otherwise, what are you going to do?

You work with what you have, as best as you can. That’s what we’re all doing. Even psychiatrists.