Psychiatry bashing

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Teufelhunden

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typeB-md said:
yes, there is a reason psychiatry exist, it's because they needed a place to stick all of the nutjob medical students who couldn't interact with other normal people. psychiatrists are weird and the stuff they come up with is even more weird. I'm not denying that neurolgical problems exist because of course they do. I'm simply saying that i think overall they are quacks who take advantage of the needy. I'll stop at that because i could write a thesis on how weird these folks are.

Okay, the point of this thread is not to start a cross-forum flame war with typeB-md. In fact, I'd like to use his comments as fodder for a positive discussion. As a future psychiatrist, I'm interested in discussing:

  • Why does this stigma exist?
  • To what degree is our profession responsible for this stigma (versus how much of it results from negative media portrayals of psychiatists)?
  • What can we (current and future) psychiatrists do to improve our image (A) amongst our colleagues and (B) amongst the general public?

Listen, I've got pretty thick skin, and have so far withstood a baragge of negative comments about my chosen field (the usual stuff, defining us as "lazy" or "nutjobs, etc.) Thing is, it doesn't bother me because I don't fit that stereotype. My reputation as a medical student has been, if nothing else, as someone who works his a** off. As far as being a "nutjob," well I think that's pretty subjective. Hell, I think anyone who'll willfully suffer through a surgery resideny is a "nutjob" j/k ;)

Anyway, I'm interested in hearing your thoughts on this.

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Teufelhunden said:
Okay, the point of this thread is not to start a cross-forum flame war with typeB-md. In fact, I'd like to use his comments as fodder for a positive discussion. As a future psychiatrist, I'm interested in discussing:

  • Why does this stigma exist?
  • To what degree is our profession responsible for this stigma (versus how much of it results from negative media portrayals of psychiatists)?
  • What can we (current and future) psychiatrists do to improve our image (A) amongst our colleagues and (B) amongst the general public?

Listen, I've got pretty thick skin, and have so far withstood a baragge of negative comments about my chosen field (the usual stuff, defining us as "lazy" or "nutjobs, etc.) Thing is, it doesn't bother me because I don't fit that stereotype. My reputation as a medical student has been, if nothing else, as one who works his a** off. I've been offered residency spots on almost every service I've rotated on. As far as being a "nutjob," well I think that's pretty subjective. Hell, I think anyone who'll willfully suffer through a surgery resideny is a "nutjob" j/k ;)

Anyway, I'm interested in hearing your thoughts on this.

I have a few thoughts on your questions:

Why does this stigma exist? For the same reasons that there is a stigma about mental illness in general. People are afraid of things they don't understand and which are unpredictable. So they marginalize those things so they can avoid the fear. Our colleagues are people too, and unfortunately some of them fail to understand psych issues, particularly those who need to see tangible evidence of improvement which we don't always see in our field.

Are we responsible for the stigma? I don't think we are responsible for the stigma about psychiatry any more than you would say a schizophrenic is responsible for the stigma of mental illness. There are probably more psychiatrists who have mental illness themselves than in the general physician population, but this should not be surprising. I know many people who went into ortho because they had multiple sports injuries, or perhaps into pediatrics because they were ill as a child and had a wonderful pediatrician. It only comes up in psychiatry because there is a stigma related to mental illness. No one would fault that ortho resident because he or she once had a knee replacement. Furthermore, to generalize and say that all psychiatrists are crazy or quacks is akin to saying that all Asian people are good in science, or all Jewish people are good with money. (I mean no disrespect, just proving a point) Psychiatrists provide a valuable service, and unfortunately I think the doctor you have quoted probably has patients who are missing out because of his or her own prejudice.

What can we do to improve our image? Three things come to mind:
1) Be a good psychiatrist yourself. Your colleagues will notice.
2) Communicate effectively with your patients other providers and be a useful member of the care team
3) Educate physicians and the public about mental illness and what we as psychiatrists can do to help people.

As just an afterthought, whenever I feel like I'm being judged for my career choice and I'm feeling a little down about it, I try to think of all the patients I have helped who are often marginalized by society and sometimes ignored by the rest of the medical profession. And if I need something a little more tangible, I consider that one of the most common causes of death, particularly among younger people, is suicide. We save lives, just like our non-psych colleagues.
 
1. I agree with meisteckhart. People ridicule and abhor what they don't understand. Until relatively recently, psychiatric illness was very intangible, and had scant and conflicting support in the scientific literature. Anyone who currently states that psychiatric illness or its treatments are not explained through at least biological mechanisms doesn't know psychaitric science at all. This isn't to say that environmental influences don't create personality dynamics - I'm referring more to the severe mental illnesses.

2. The profession isn't responsible, in my opinion, for this "stigma." No one berates internal medicine doctors for their ancient practice of blood-letting for any and all diseases. Their treatments have modernized. So has psychiatry's. The nature of psychiatric illness (non-visible, untestable, low "cure" rate, strange manifestations) are non-understandable to many. This causes them to behave in the ways they do.

3. To be honest, I'm not interested in changing my image in front of my colleagues. I plan on practicing good psychiatry from a medical model. If my work causes others to think better of psychiatry, then so be it. I see everyday the differences that psychiatrists make in patients' lives. Families that are tearful over the joy that their son or daughter has clinically improved so dramatically with treatment. That's good enough for me.

That said, since politically correct pushiness forces awareness of all types of other conditions, it could theoretically be done also with psychiatry. Perhaps the APA could do a better job of this.
 
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From a non-MD health professional, I think that a lot of it has to do with fear of mental illness. In my experience, everyone bashes psychiatrists (and psychologists, for that matter) until they need one. The social construct of "self vs. other" keeps people from realizing that the 'line' (whether biological or environmental) is much closer to them than they think.

In short, it's much more comfortable to villify what we are afraid of then to feel it breathing down our neck.
 
Here is WHY typeB-md wrote what he did:
what IS the case though, is that i believe there is GROSS misdiagnosis of psychiatric illness. I would venture to say that many people who are depressed are not suffering from a biological pathology but normal variations in emotion due to some external stimulus. I've seen people in the psych clinic give out SSRIs for someone who had their mother pass away one month ago and because they "don't seem to enjoy what they used to." Now i have to say that i would be hardpressed to believe that this individual was suffering from major depression. In the end this just postpones the natural grieving process.

and i'll tell you where my beef with psychiatrists come from. first of all they charge around $155/hr which is a crock of **** b/c many of their patients aren't very financially well-off anyway. And then after they establish this rapport with the patient, if they can't pay, well it's goodbye to them. So now they've caused even more psychological harm and taken advantage of a mentally ill patient. You can disagree with me, but then you're problem in "denial."

and psychiatry is not the only field where drugs are pushed. (...)
At least take someones rant in context! Here is the link to the entire thread. http://forums.studentdoctor.net/showthread.php?t=188720
 
MSHell said:
Here is WHY typeB-md wrote what he did:

At least take someones rant in context! Here is the link to the entire thread. http://forums.studentdoctor.net/showthread.php?t=188720

This doesn't really change our discussion at all, nor does it change my opinion of what he said. First of all, most of our discussion has been about where these opinions come from and how we as psychiatrists can help to improve our own image, if we feel it is our responsibility at all. In reference to your assertion that his comments were taken out of context, would you like us to quote everything he said in all of his previous posts? I don't think it would change much, given that the small amount you have posted in addition, still seems to imply that he is prejudiced against psychiatry for relatively unfounded reasons.

I think by looking at the expanded portion of type B md's post, you can see that many of his accusations are still either unfounded, or consisting of a generalization of the entire field of psychiatry based on a few of his/her own experiences. First off, I am going to refrain from my usual arguments related to the assertion that psychiatric issues are just normal extremes of human emotion. If that isn't obviously related to the stigma of mental illness, I don't know what is. I will say, however, that whether you believe mental illness is truly disease or not, these people are suffering and deserve treatment both for their sake, and for the safety and wellbeing of society as a whole. Secondly, no good psychiatrist would prescribe an antidepressant for what is clearly a normal grief reaction. However, if a person has a significant impairment related to their grief, such as loss of weight or perhaps suicidal thoughts, than it is not a normal grief reaction and needs to be treated.

I address the money issue last, mostly because I think it is absolutely ridiculous. First of all, psychiatrists probably treat more people on disability and who cannot pay for their care as a percentage of their patients than any other medical specialty. Many other specialities wouldn't want to take care of the severely mentally ill, nor would they even know where to begin in order to do so. The business of medicine is the same regardless of what specialty you practice in. There are plenty of surgeons, internists, pediatricians, etc who refuse to take patients for one reason or another if they will not get reimbursed. Still, many psychiatrists take a small portion of patients who cannot pay at all simply because they want to be of service, and make up for this with the rest of their practice. Or they may volunteer their time, or work in the public sector. To imply that most if not all psychiatrists are motivated by money makes absolutely no sense. We have some of the lowest incomes of all specialties on average. If I had wanted to get rich and drive fancy cars, I would have been a surgeon, or better yet, not gone into medicine at all.
 
But your whole "conversation" has been based on one comment taken out of one thread. So I posted the link (which, was not in the OP's original post) if you were curious enough to want to read it.
 
MSHell said:
But your whole "conversation" has been based on one comment taken out of one thread. So I posted the link (which, was not in the OP's original post) if you were curious enough to want to read it.

Wow, I just read through that thread, and that's some funny ****!

I've never seen somebody so willing to play the fool, over and over again. Dogmatic exercise crusader! LOL!!! I'm not surpised that such a comment came from him.

As for why psychiatrists get a bad rap, alot of it has to do with bad marketing. I've met radiologists who use the terms psychiatry and psychology interchangably. In the past few years, what exposure has psychiatry recieved in our popular culture?

Example 1. Jennifer Melfi, psychiatrist of Tony Soprano - an analyst who prescribes prozac for Tony's panic attacks, and is obsessed with talking about Tony's mother, and analyzing Tony's odd dreams.

Example 2. Billy Crystal, hapless psychiatrist of mob boss Robert Deniro in Analyze this/that.

Example 3. Desparate Housewives - after refusing to medicate her "boys being boys" for several episodes, a mother "gives in" to social pressures, then abuses her son's ADHD drugs for extra stay at home mom pep, an inevitable consequence of having stimulants around the house.

Example 4. Christopher Pittman takes Zoloft at 12 years of age, kills grandparents with a shotgun, lighting the house on fire and stealing their car. Forensic psychiatrists on both sides of the case argue for and against the drug being the reason.

Good or bad, accurate or not, to much of america, these are the images that create the foundation for our conception of psychiatrists and the field of psychiatry in general. These formative portrayals are as important as any clinical experience MD's recieve in their 3rd year training. Perhaps more so, as most people will have produced a strong opinion about psychiatry before recieving training anyways.

Scientologists are better at marketing anti-psychiatric ideas and images, than psychiatrists are at producing an accurate depiction of their profession.
To many in the medical community, psychiatrists are still Freudian hand holders who practice a non-falsifiable religion as much as they do medicine.

Hey, the subconcious is a subversive and unprovable idea, especially to control freaks who believe they can bench press their way to happiness.
 
Janusdog said:
From a non-MD health professional, I think that a lot of it has to do with fear of mental illness. In my experience, everyone bashes psychiatrists (and psychologists, for that matter) until they need one. The social construct of "self vs. other" keeps people from realizing that the 'line' (whether biological or environmental) is much closer to them than they think.

In short, it's much more comfortable to villify what we are afraid of then to feel it breathing down our neck.

I would wager that nothing instills fear into the minds of the lay public as quickly as cancer. Yet oncologists, rad-oncologists, or even surgeons who specialize in cancer, are quite prestigious occupations among the lay public. So a fear of the disease that a doctor treats is certainly not a reason for the public to fear and mistrust a doctor.

The main reason the public doesn't give much respect to psychiatrists is because they can't differentiate them from psychologists. You would be shocked at how many people don't know what in under to be a psychiatrist one has to graduate from medical school. If they knew the effort becoming a psychiatrist entailed, they would realize that this is a serious occupation.

A large part of the problem stems from psychiatrists association with psychologists. The public often doesn't know the difference. And, psychologists, to many members of the lay-public are charlatans who earn a pretty penny for sitting on a couch doing nothing. No drugs, rarely advice, just listening. If you don't believe me, ask around town what the difference is between a psychiatrist and a psychologist. Or how one can become a psychiatrist. You'll be shocked at the responses.

You're not the only ones. Radiologists-Radiology Technicians and Ophthalmologists-Optemetrists-Opticians also have these problems.

Like I said, the main problem is that the public doesn't realize psychiatrists are doctors. Doctors still are given a lot of prestige and respect in society.
 
To many, "mental disease" vs "cancer"

is equivalent to "free will" vs. "large tumor"

You can choose to be mad or not, wheras you have no choice if you have a tumor (unless u smoke - then u deserve to die). You can touch tumors and cut them out. You can't touch a person's choice nor dig it out of somebodies mind.

If somebody is depressed, it is because they are lazy and simply won't get up and exercise (I am paraphrasing type-b's argument here). A behavior isn't a symptom, it's a choice.

Therin lies the difference - the separation of mind and body. A doctor is somebody who takes care of somebodies body, a psychiatrist takes care of somebodies mind/free will. As you cannot cut and splice free will, you must manipulate it. Here is the source of some of the fear and suspicion that psychiatrists manage to stir up as well.

Current research in psychiatry are using genetic and imaging modalities in an attempt to link behavior and mental disease to human genes, physiology, or anatomy in an attempt to shift away from this limited concept and into a more cohesive interconnected one. For example, if psychiatry researchers can show that there is a consistent volumetric size difference in the size of the putamen in treatment naive OCD children, which diminishes after treatment, this is an important little step in this gradual paradigm shift.
 
I'veGotBigBalls said:
To many, "mental disease" vs "cancer"

is equivalent to "free will" vs. "large tumor"

You can choose to be mad or not, wheras you have no choice if you have a tumor (unless u smoke - then u deserve to die). You can touch tumors and cut them out. You can't touch a person's choice nor dig it out of somebodies mind.

If somebody is depressed, it is because they are lazy and simply won't get up and exercise (I am paraphrasing type-b's argument here). A behavior isn't a symptom, it's a choice.

Therin lies the difference - the separation of mind and body. A doctor is somebody who takes care of somebodies body, a psychiatrist takes care of somebodies mind/free will. As you cannot cut and splice free will, you must manipulate it. Here is the source of some of the fear and suspicion that psychiatrists manage to stir up as well.

Current research in psychiatry are using genetic and imaging modalities in an attempt to link behavior and mental disease to human genes, physiology, or anatomy in an attempt to shift away from this limited concept and into a more cohesive interconnected one. For example, if psychiatry researchers can show that there is a consistent volumetric size difference in the size of the putamen in treatment naive OCD children, which diminishes after treatment, this is an important little step in this gradual paradigm shift.

I'veGotBigBalls makes some good points. (and apparently he's well endowed as well) I think the mind/body divide is certainly a problem and although people are afraid of both mental illness and cancer, they do treat mental illness differently because many believe it is something you can just stop by sheer will power. I would agree, however, that the public in general is very undereducated about the training necessary to be a psychiatrist, though I think there is more to their perception of psychiatry than simply understanding the difference between psychology and psychiatry. Take as evidence that psychology suffers the same stigma as psychiatry does, thus I think both of our professions suffer under the burden of mental illness being marginalized.

The bad marketing argument intrigues me, since you could argue against it from a chicken and the egg perspective. In other words, are media portrayals of psychiatrists causing the public to have relatively negative images of the profession, or are the publics relatively negative images of psychiatrists causing media portrayals of the profession to appear negative. I think I would tend to think that the image of psychiatry came first, and that media portrayals of psychiatry serve to reinforce that image. Of course, at this point, it doesn't really matter which came first since you certainly do need to change those portrayals of psychiatrists in the media in order to help change the image with the public.

One more thing. I sat here trying to think of just one realistic, positive image of psychiatry in the movies, and I couldn't come up with one. Does anyone know if there has been any research or thought into this area? I know there has been research on the portrayal of doctors in general in movies and the media. More importantly, can anyone remember a positive depiction of psychiatrists in movies or the media?
 
[One more thing. I sat here trying to think of just one realistic, positive image of psychiatry in the movies, and I couldn't come up with one. Does anyone know if there has been any research or thought into this area? I know there has been research on the portrayal of doctors in general in movies and the media. More importantly, can anyone remember a positive depiction of psychiatrists in movies or the media?[/QUOTE]

Just saw "Ray" last night. The scene with the psychiatrist was brief, but profoundly positive and, interestingly, it touched on both the physiological (in this case opiate withdrawal) and psychological aspects of clinical psychiatry.
 
Here's one!
 

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Heather Graham on Scrubs is depicted as a psychiatrist who is happy, competent and exudes empathy. Not to mention, hot! She can psychoanalyze me anyday, :love: hubba hubba.
 
Psychiatry and Mental Illness: Are They Mass Media Targets?

by Michael Jonathan Grinfeld

Psychiatric Times March 1998 Vol. XV Issue 3

Psychoanalysis-contagious disease originating Vienna circa 1900-now extinct in Europe but occasional outbreaks among rich Americans. - 3001: The Final Odyssey, by Arthur C. Clarke

Nothing is sacred in America's pop culture. So when it embraces any topic, we've grown used to the relentless distortion that occurs, one that transforms reality into an odd combination of fact and fantasy. For those suffering from mental illnesses and the practitioners who treat them, the implications of a steady onslaught of often negative and inaccurate portrayals of mental illness in all forms of entertainment media are dire.

Battling the societal stigma that enshrouds brain diseases is difficult, and the ability to overcome centuries-old biases is often thwarted by the stereotypical representations of mentally ill individuals, as well as psychiatrists, psychologists and other therapists. The issue is nothing new, but the latest spate of movies, books and TV shows that involve mental health issues renews concerns that rather than progression there is a backslide into prejudice that militates against understanding.

Often the slights are not intentional, according to Jean Arnold, chair of the National Stigma Clearinghouse, a New York City-based hub of information for "stigmabusters" nationwide. In her experience, the creators of entertainment don't understand the harm they do when they include stereotypical depiction of mental illness.

"These people don't really mean to harm the mentally ill," Arnold said. "They do it inadvertently because they think that [using stereotypes] is the easiest route to take. But they're willing to change. They're not intending to be offensive once they're sensitized," Arnold said. She added that the entire mental health community needs to be more outspoken and willing to take on the entertainment industry when it steps out of line.

The publicity surrounding Woody Allen's latest release, "Deconstructing Harry," however, suggests that sometimes the motives for negative portrayals may be driven by "not-so-hidden" agendas. In the film, Kirstie Alley plays the role of a psychiatrist, one whose boundary breaches and neurotic emotional state are typical of the way psychiatrists are often portrayed in the media.

In a Dec. 11, 1997 USA Today article, Alley told the interviewer, "I don't like psychiatry. And I don't believe it works. And I believe psychiatrists are neurotic or psychotic, for the most part. I wanted to play her that way, and Woody just totally let me do it. I said, 'I want to be taking Prozac or drugs during the session with her patient.' I wanted to show that this woman is so twerked out that she has to take drugs, too. She takes her own medicine. So he said, 'Yeah! That's a good idea.' "

Efforts to reach Allen through his publicist to discuss his portrayal of mental health-related subjects in his movies were unsuccessful. But in the same USA Today article, he was quoted as saying, "I didn't give her even one direction. I never had to. Her instincts were right on from the start."

Alley is a member of the Church of Scientology and the international spokesperson for Narconon, the church's program for drug and alcohol abusers. The church, through various affiliated groups, has publicly denounced psychiatry and psychiatric care.

Allen, meanwhile, has become the unwilling national icon for critics of mental health benefits parity, whose use of the term "Woody Allen Syndrome" connotes endless, pointless and often useless therapy, the cost of which will allegedly bankrupt the health care system.

Impressions created by members of the entertainment media, whether intentional or not, have a profound impact on the public, according to Glen Gabbard, M.D., author of the book Psychiatry and the Cinema. Originally published in 1987, an updated edition is scheduled for release next year by the American Psychiatric Press.

"Movies, to the American public are like what Greek drama was to ancient Athenians. They shape our culture and they shape our attitudes," said Gabbard, the Callaway Distinguished Professor at the Menninger Clinic in Topeka, Kansas. "Ever since McLuhan, we know how influential the electronic media is in shaping the culture."

Whether in the depiction of psychiatrists or mental illness, the history of cinema has not been kind, according to Gabbard, who can reel off the names of movies and their release dates with the ease of a seasoned film buff. Except for a "golden age" between 1957 and 1963, when 22 movies were produced featuring idealized portrayals of therapists, and a few exceptions in other years, neither psychiatrists nor the mentally ill have fared well.

In the past 30 years, Gabbard said, only three movies have portrayed therapists sympathetically-"I Never Promised You a Rose Garden" (1977); "Ordinary People" (1980): and "Good Will Hunting" (1997). In the latter film, although Robin Williams portrays a sensitive, understanding therapist struggling to help a gifted, but troubled, youth, the depiction of what Gabbard called "outrageous and preposterous therapy" detracted from the overall positive images in the film. "Therapy is seen as helpful and maybe some people will go to therapy because they see it as being helpful," Gabbard said. "What they expect when they get there is going to be a problem."

Gabbard observed the opposite phenomenon in "As Good as it Gets," the 1997 release that garnered Golden Globe awards for both of its stars, Jack Nicholson and Helen Hunt. While the psychiatrist portrayed in the movie actually exhibited good professional boundaries, he came across as affected and rigid. "It shows the contradiction that what might be good psychiatric practice may not look good to the public in a movie, but ... outrageous psychiatric practice [may] look good [if the therapist] is human, warm and fuzzy," Gabbard said. Nevertheless, the movie was the only one in the history of filmmaking, as far as Gabbard could tell, that suggested medications could be helpful in the treatment of mental illness.

The entertainment industry treats the mentally ill as they do mental health practitioners-poorly. Gabbard, like other sources interviewed for this article, agreed that the portrayals were usually equated with violent or comically affected behavior, but rarely as functional.

Otto F. Wahl, Ph.D., a clinical psychologist and professor of psychology at George Mason University in Fairfax, Va., said the cumulative effect of constant negative depictions of the mentally ill profoundly impacts not only the general public but also those who suffer from mental illnesses. The most significant misrepresentation, he told Psychiatric Times, is the link created by entertainment media between mental illness and violence. The appearance of "psycho killers" in movies, books and children's television programs is at epidemic proportions.

"Wag the Dog," a recently released, award-winning movie starring Dustin Hoffman and Robert DeNiro, for instance, depicts a psychotic, mentally ill soldier who constantly pops antipsychotic medication into his mouth like candy and is then killed while raping a young woman.

"It increases stigma by perpetuating the negative attitudes that people with mental illnesses encounter and fear," Wahl said.

His book, Media Madness: Public Images of Mental Illness, was released again in paperback last October, and his work with the National Stigma Clearinghouse earned him the American Psychiatric Association's Patient Advocacy Award in 1997. "People with mental illnesses are also readers and viewers of those images; they are shamed by them and they're embarrassed by them. They're aware that they are depicted in negative ways and it damages their self-esteem, it damages their confidence, and it increases their likelihood that they won't tell anyone about their illnesses. So they're not going to seek treatment."

Not everyone in the entertainment industry is hardened to the sensibilities of individuals suffering from mental illness and the practitioners who treat them. Someone who walks the tightrope between acceptable satire and insensitive mockery on a daily basis is Jonathan Katz, a standup comic and one of the creators of "Dr. Katz: Professional Therapist."

"I try to be as vigilant as possible because I know that the pain of a mental illness is no different than the pain of a physical illness," Katz said in an interview with Psychiatric Times. "I have had bouts of depression. I have friends who suffer from various forms of mental illness."

(cont'd)
 
(cont'd from above)

An adult-oriented, animated television show, "Dr. Katz" is entering its fifth season on cable's Comedy Central station, carried into 46 million homes nationwide. A self-described combination of "obsessions, compulsions and comedy," it chronicles the lives of psychiatrist Katz-who is as "phobic and obsessive as his patients"-his wayward, adult son, and his "short on interpersonal skills" secretary. The show has spun off a nationally syndicated comic strip seen in over 200 newspapers and a published collection of the cartoons called "Dr. Katz: Hey, I've Got My Own Problems."

Katz conceded that "It's very hard to do comedy without offending someone," but he tries "to be as sensitive as possible to the issues of mental illness."

"This is a segment of society that does not have the same kind of advocacy as other illnesses, Katz said, adding "It still has a stigma attached to it." His show steers clear of disparaging terms such as "wacky" and "fruitcake," and totally avoids mention of serious mental illnesses.

In one episode, however, a "patient" laments, "I've been in therapy now...21 years, and what I would really like to know is when I am going to get better? I'm still agoraphobic, and I still don't know what it means." Mental health advocates often cringe at stereotypical characterizations of ineffectual mental health care, saying that treatment outcomes are often better for mental illnesses than for physical ones.

But Katz said he has never received any complaints about the show's content, and he would be "upset" if he felt he was contributing to stigma or to people hesitating to obtain care. "I'm actually a believer in therapy. I've had good experiences with it myself," he said.

At one point last year, Katz and his creation "Dr. Katz" were slated to be part of a citywide antidiscrimination campaign sponsored by New York City's Department of Mental Health, Mental ******ation and Alcoholism Services. But the $250,000 media blitz aimed at dispelling the stigma of mental illness stalled last June when the department and the advertising agency hired to run the campaign parted ways.

Suzan Mullin, the department's director of public education and community affairs, who is now responsible for the campaign, said they expect to hire a new public relations firm, and a roll-out is now scheduled for late this spring. The emphasis of the antistigma campaign will be redirected toward employment opportunities and the availability of mental health services. She said the decision not to go forward with using "Dr. Katz" centered around peoples' lack of familiarity with the image and their inability to relate to it.

Smiling Through Tears, a recently published book by Pamela Freyd, Ph.D., and Eleanor Goldstein addresses the recovered memories controversy using a combination of cartoons and text. Freyd, an education researcher, is the executive director of the Philadelphia-based False Memory Syndrome Foundation, while Goldstein is the author of a previous works on the same subject, including Confabulations, Creating False Memories-Destroying Families and True Stories of False Memories.

In this latest work the authors use cartoons that lampoon mental health-related topics, therapy and therapists to buttress their view that "through the use of mind-altering techniques therapists have contributed to the devastating damage inflicted upon tens of thousands of families." Both Freyd and Goldstein, however, told Psychiatric Times that their book was never intended to disparage appropriate therapy and competent mental health practitioners.

"We would never be against psychotherapy per se," said Freyd. "Indeed, psychotherapy, therapy in general, and all of psychiatry is tremendously important to our society. People should have confidence when they turn to it."

Nevertheless, she conceded the book may not have made sufficiently clear that appropriate treatment is available, too. "In terms of guidelines for what one could expect or what are the things to look for in good or bad mental health care, that is not something that we included in this book, because it wasn't something that we felt was necessary for the story that we were telling," she said. "Perhaps that was an oversight."

Another recently published book, "Freudian Slips," by cartoonist Sidney Harris, also presents a satirical portrayal of therapy and therapists. The book is a collection of his works over the past two decades, and the comics originally appeared in magazines such as The New Yorker, Playboy, Science and National Lampoon. At one point, Harris said that his work even appeared in the APA's Psychiatric News.

He doesn't believe his form of humor adds to any stigma of the mentally ill and denies that he "is advocating anything." Harris tends to create cartoons about subjects that interest him, and he cautions against hypersensitivity that would prevent people from appreciating the humor in his work.

Meanwhile, the mental health community continues to gear up its efforts to combat stigma. The National Alliance for the Mentally Ill already has an antidiscrimination campaign underway, and the National Mental Health Association and the APA have made efforts to turn the media around to a more sympathetic and accurate point of view.

But according to Menninger's Gabbard, although the media has sometimes realized its potential to educate the public about mental health, fictitious portrayals won't get significantly better as long as stereotypes of the mentally ill and the practitioners who treat them continue to entertain the American public. "As long as the box office is the bottom line, accurate depiction of mental illness and psychiatry will never be seen."
 
OldPsychDoc said:
Your transference is showing... ;)

I must admit I like Heather Graham's character... uh... for um... various reasons. Admittedly, she does have some positive contributions as well on the show, and is probably a step up from Hannibal. You must admit though, she fits the stereotype of the absent minded, somewhat strange psychiatrist who probably has some significant issues of their own. She just happens to also be hot.
 
sacrament said:
Here is the sequel:

http://forums.studentdoctor.net/showthread.php?t=190804


For somebody who rants about psychiatrists, if anybody on that thread needed one, it was typeB.

Both of those were really funny. However, I apologize for posting the link. I did this before it degenerated past the point of no return.

There is, however, a lot to be said for healthy body = healthy mind.

A previous poster described other specialties having issues too: optho vs optometrist and optician; radiologist vs rad tech. so this issue about confusing psychiatrist with other mental health professionals is not unique to this branch of medicine.

Seriously, how many non-medical people (even medical ones i wager) know what a pathologist does? a hesitant "autopsy" response could be ellicited, but others??? Don't go looking at SDN path for a real answer - I've given the warning ahead of time.
 
I have emailed/called/met with a small handful of psychiatrists and asked them this same question, whats up with the stigma against psychiatrists/i heard they are not respected/i heard they are thought of as pill pushers/etc. The responses they had in common were that they have never really felt disrespected by their MD peers, either in school or professionally. In some few instances psychologists and other mental health workers may have had the wrong idea about what they have to offer (similar to the general public), but they all pretty much said that they (psychiatrists) are a big part of why they have such a rep. Because most psychiatrists really are pill pushers.

One guy who is a psychologist and psychiatrist was very adamant that psychiatrists, maybe as a result of having gone thru medical school, are inflexible and uncreative thinkers, and make poor researchers/scientists, compared to psychologists.
 
gaki said:
I. Because most psychiatrists really are pill pushers.
And now psychologists want to join the bandwagon :rolleyes:
 
gaki said:
One guy who is a psychologist and psychiatrist was very adamant that psychiatrists, maybe as a result of having gone thru medical school, are inflexible and uncreative thinkers, and make poor researchers/scientists, compared to psychologists.

Funny, some of the most cerebral, flexible and innovative thinkers I know are psychiatrists. Particularly those deeply involved in either psychodynamics or psychopharmacology.
 
Anasazi23 said:
Funny, some of the most cerebral, flexible and innovative thinkers I know are psychiatrists. Particularly those deeply involved in either psychodynamics or psychopharmacology.

I would tend to agree. In fact, one of the reasons I like psychiatry myself is that it seemed to be one of the specialties in medicine that nurtured creative thought. And I would have to say that I have yet to meet a psychiatrist who I would describe as inflexible. (though some are more flexible than others) Being able to adapt to each patient and their unique problems is sort of a large part of the job.
 
Teufelhunden said:
Alley told the interviewer, "I don't like psychiatry. And I don't believe it works. And I believe psychiatrists are neurotic or psychotic, for the most part.

To understand this in context you need to remember that Kirstie Alley is quite a hard-core Scientologist, a cult started by failed science-fiction writer Lafayette Ronald Hubbard back in the 1950s. He cobbled together a weird mish-mash of random pop-culture perceptions of mental illness, some bizarre science-fictional themes about alien slug-like invaders ("thetans") from beyond time and space, and an undying hatred of psychiatrists. Scientologysts are constantly cautioned against believing anything psychiatrists or pscyhologists have to say, and are told repeatedly that existing models of mental illness as rooted in neurotic, neural or psychopharamacological models are bogus.
http://www.scientology.org/en_US/religion/heritage/pg011.html
Convinced that man is only a body, psychology and psychiatry have forwarded the idea that there is no soul, merely a physical brain, an aggregation of tissue and nerve cells.

And since man no longer has a soul, he can be degraded still further through all manner of barbaric “treatments.” In fact, the array of primitive methods dreamed up by “modern” psychiatrists includes hypnotic drugs, lobotomies, electric shock and bolts to the brain while a person is drugged and comatose — each of which leaves a person little more than a vegetable.
http://www.solitarytrees.net/cowen/misc/psywar.htm
Hubbard demanded in "Project Psychiatry" that Scientologists and Scientology-hired private investigators should find:

Psychiatric bloodsports. Psychiatric Auschwitz all proven by individual cases ...

We want at least one bad mark on every psychiatrist in England, a murder, an assault, or a rape or more than one.

This is Project Psychiatry. We will remove them.
http://en.wikipedia.org/wiki/Scientology_beliefs_and_practices#Scientology_and_psychiatry
Scientology rejects the claim that mental diseases can have biological basis and holds that such diseases are caused exclusively by disturbed thought processes which can be corrected by Scientology counseling. On the other hand, the Church of Scientology has policies which forbid the counseling of mentally ill people or those who have received psychiatric treatment. The organization has been known to refuse assistance for persons suffering from notable mental disorders; for some, it has developed special procedures for "handling" these problems, such as the Introspection Rundown.

A Scientology sister organization, the Citizen's Commission on Human Rights (CCHR) has been formed to promote this viewpoint. The CCHR's Web site (http://www.cchr.org) lists various publications put out by the organization that attack the field of psychiatry, including Psychiatric Rape—Betraying Women, Psychiatry: Education's Ruin, Psychiatry: Victimizing the Elderly, and Psychiatry's Betrayal—Creating Racism. The CCHR does not publicize its connection to the Church of Scientology.
http://www.clambake.org/archive/books/bfm/bfmconte.htm
 
CCHR is also the home of the most prominent anti-psychiatrist of all, Dr. Szasz.

Though I can appreciate some of his criticisms (intellectually, if not clinically) of psychiatry, his association with the Scientologists is (IMO) most disappointing.
 
I come from a country where Psychiatry is not quite as popular as it is in the US. (When someone manifests with mental illness, the first thing the common masses think is, the person is possessed by an evil spirit). I've expressed my interest in this field and my relatives are against it. I think it's because they fear that if I do indeed become one, I'd be "useless" to them versus if I became a pediatrician or cardiologist or dermatologist.
 
hedera916 said:
I come from a country where Psychiatry is not quite as popular as it is in the US. (When someone manifests with mental illness, the first thing the common masses think is, the person is possessed by an evil spirit). I've expressed my interest in this field and my relatives are against it. I think it's because they fear that if I do indeed become one, I'd be "useless" to them versus if I became a pediatrician or cardiologist or dermatologist.

Or maybe not...and that's what really scares them!
 
^Yeah I know, that's what I told them.:smuggrin:
 
I think the guy with the 'big balls' hit the nail on the head with respect to the origin of the stigma with psychiatry. On some level, the average person is still enmeshed in the notion that the mind(= immaterial soul, = spirit) is fully divorced from the body, and therefore pure free will exists - as a result, negative mind states are purely a matter of free choice. Consequently, any attempt to 'mess' with the mind is also an attempt to mess with the soul, and therefore all the more suspect. People don't intellectually or emotionally feel comfortable with the idea that emotions could be somehow related to neurochemistry. They fear that accepting this connection could lead to rigid determinism or moral laxity towards criminals. It also might threaten aspects of their spiritual worldview. Psychopharmacology also challenges what may be an innate tendency towards dualism (might want to check out "Descartes Baby" for more info on that).

Now, I'm not going to debate the objective merit of the popular dualistic viewpoint (I'm no philosophy major). And obviously emotions are partly under our conscious control, otherwise talk therapy wouldn't work, etc etc. But I think understanding the pervasive dualistic worldview helps us understand the origin of the stigma against psychiatry.
 
"you can choose to be mad or not"

as an aspiring psychiatrist, i award you an e-bitchslap for this remark.

carry on, all.

Z
 
Further about the Scientologists view on Psychiaty from above...

Tom Cruise gave an interview recently where he berated Psychiatry...
He said there was no reason for medication in Psychiatric illnesses and that people who are depressed/psychotic/whatever should go, for example, on long walks in Nature to calm them. and he was serious.

As for positive Psychiatrist characters on t.v, how about the Asian guy on Law & Order: S.V.U.? He's awesome...
 
Tom cruise is a weirdo, its amazing how celebrities think they're smart and knowledgible on everything from politics to medicine.

Psych is such an amazing field to go into, psychiatrists prevent so many senseles suicides, and help people cope with their illnesses so they can return to being a functioning members of the society.

Its a shame that the general public and some people on these boards don't realize what a vital function psychiatrists provide.

Anyways, I think psych is great, I'll be doing it in 2006 match!
 
Tom Cruise's interview with Entertainment Weekly...
Your comments about antidepressants on Access Hollywood — do you think going after Brooke Shields for her book about postpartum depression might have made the argument a little too personal?
It's not a matter of making it personal. I care about Brooke. I want to see her do well. I think she's really talented. But she's misinformed. And, you know, from that Access Hollywood interview, I've gotten over 154,000 responses from people thanking me. You should see some of the letters I get. People go for help but their lives don't get better because of these drugs. They get worse. They feel numb and they're told that's a good thing. It's becoming like Huxley's Brave New World. It's like what the English did to China with opium [in the 19th century]. How is this different? It's how you degrade a society — by drugging the piss out of it.

You are aware that your views about psychiatry come across as pretty radical to a lot of people.
In the 1980s, you were supposed to say no to drugs. But when I say no to drugs, I'm a radical? 'He's against drugs — he's a radical! He's against electroshock treatments — he's a radical!' [Laughing] It's absurd!

Yeah, but Scientology textbooks sometimes refer to psychiatry as a ''Nazi science''...
Well, look at the history. Jung was an editor for the Nazi papers during World War II. [According to Aryeh Maidenbaum, the director of the New York Center for Jungian Studies, this is not true.] Look at the experimentation the Nazis did with electric shock and drugging. Look at the drug methadone. That was originally called Adolophine. It was named after Adolf Hitler... [According to the Dictionary of Drugs and Medications, among other sources, this is an urban legend.]

Well, Freud wasn't a Nazi, but the point I'm getting at here is that expressing these views isn't necessarily a public relations bonanza for you.
What choice do I have? People are being electric-shocked. Kids are being drugged. People are dying.
 
MSHell said:
Here is WHY typeB-md wrote what he did:

At least take someones rant in context! Here is the link to the entire thread. http://forums.studentdoctor.net/showthread.php?t=188720
i think 155 per hour is cheap for what they do.. seriously..

its a good field because no other physician will come close to understanding psychiatric illness..
 
Miklos said:
CCHR is also the home of the most prominent anti-psychiatrist of all, Dr. Szasz.

Though I can appreciate some of his criticisms (intellectually, if not clinically) of psychiatry, his association with the Scientologists is (IMO) most disappointing.

I've wondered ever since seeing that Wikipedia entry what Dr. Szasz's role at SUNY Upstate is. Does he teach? If so what is psychiatry training like there?

I'm also disappointed about his association with Scientology, it makes it harder to take his criticisms seriously, valid or not.
 
Kazema said:
I've wondered ever since seeing that Wikipedia entry what Dr. Szasz's role at SUNY Upstate is. Does he teach? If so what is psychiatry training like there?

I'm also disappointed about his association with Scientology, it makes it harder to take his criticisms seriously, valid or not.

Considering his age, I'll assume that he is long retired.
 
Maybe we should let Mr. Cruise go on long nature walks with psychiatric patients. See how long he last!!
 
allendo said:
Maybe we should let Mr. Cruise go on long nature walks with psychiatric patients. See how long he last!!


I'd like to see him try to manage my unit for a couple of days with his "Hubbard-o-Matic" "E-meter"... Better still, see if he can physically survive the psychotic ward upstairs with his quackery.
 
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