where are the men in psychiatry/mental health?

[Wilf]

What's wrong with Rand Paul?

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[vistaril]

This is the second or third time you've done the popcorn symbol Leo....sex and the city rerun night? Housewives of SoCal marathon?

 

[vistaril]

What's wrong with Rand Paul?

My issue with rand Paul, despite all the rhetoric, is that he is supposedly reactive to the needs of his poorer citizens(in terms of getting them plugged in to public dollars) in his district....it's one thing to talk a big limited spending game on the national stage, but then when you start opening my wallet to fund your voters....well that's not good.

 

[birchswing]

My issue with rand Paul, despite all the rhetoric, is that he is supposedly reactive to the needs of his poorer citizens(in terms of getting them plugged in to public dollars) in his district....it's one thing to talk a big limited spending game on the national stage, but then when you start opening my wallet to fund your voters....well that's not good.

I assume you abstain from using public infrastructure?

Income inequality threatens the political stability of a country and thus reduces its safety, something Libertarians do believe the government has a role in.

Libertarians also, as I understand it believe in free trade, as do Republicans and Democrats. As international trade has opened, income disparity between countries has decreased. But there will always be winners and losers within a country when free trade is opened. The US is capital heavy meaning those without it will lose. The capital owners in China, for example, also lose out. What are you supposed to do then with those who can't succeed because they expressly consented to changes that would advantage capital owners?

If the majority of Americans were tuned in they would see how much political power they have over MNCs. They only flourish when the political democracy—which the economy is contained within, not the other way arounds—allows free trade.

I believe in free trade, but to say there isn't a price to pay is absolutely ludicrous. And to say people need to work harder to get themselves out of poverty is either purposefully cynical or ignorant. The whole point of free trade is to abandon one factor of production for another to increase overall gains for a state. If those gains aren't shared, why allow them to begin with? Wages for those with a high-school or college education have dropped or remained stagnant for half a century. They've only increased for those with doctoral degrees. But there's only so much room at the top, which is why every country that has engaged in free trade has had to expand its redistribution efforts for those factors of production that have lost out.

By the way, the fact that you earn as much as you do is also determined by politics. If it weren't for lobbying by your industry, we could easily have a more competitive industry.

In the end, it's not your wallet. It's our wallet. And if you don't like that, there's no country for you unless you claim some deserted island. When it comes to our wallet, you get one vote like everyone else. And that wallet has already been influenced directly to benefit people like yourself. If you think doctors have lost their prestige in the US, go to Europe where they're regarded like car mechanics and make about the same wages—as it should be.

 

[Ceke2002]

the femimale psychs.

Having seen pictures of at least a couple of these so called 'femimale's' on the forum (legitimately I might add, if they happen to have a publicly accessible website), and knowing the type of men they appear to be from what I've seen of them on here, I can honestly say I'd shag or date any one of them any day of the week over your proposed image of what constitutes masculinity (provided of course they're not all currently running screaming in the opposite direction ).

Now, if you'll excuse me for a moment I have to go help my husband apply his make up for a short film shoot.

 

[HarryMTieboutMD]

I love asking self proclaimed "libertarians" and proponents of the "free market" and "individual responsibility" to explain to me Nozick and the Lockean Proviso.

Anyway, I think Vistaril and I might be alumni of the same medical school; particularly if he previously posted under a different name...

 

[notdeadyet]

I respect that stance, but I'm more of a libertarian... Do your own thing and as long as it doesn't bother me it's cool is my motto... The most freedom for everybody is what I want

Wanting "the most freedom for everyone" with the caveat "as long as it doesn't bother me" is right up there with having your choice of any color car as long as it's black. Might want to read up a lot more about Libertarianism before you start throwing the label around...

 

[Ceke2002]

isn't interested in freedom, liberty, etc....they are interested in control and restricting choice and freedom. Not good things IMOIMO

Until it takes you two weeks to get up the courage to politely ask someone out for coffee and then graciously accept when they so no, only to find yourself being grabbed by armed security guards and frog marched through a shopping centre in full view of everyone because what you've done is seen as akin to sexual assault; had a friend suddenly find themselves too terrified to be in the same room as you, because they assume you're going to rape them based solely on your sexual identity; have to endure a bus ride filled with name calling, slurs, and people pretending to be sick because you just happen to be showing affection to your partner that is well within acceptable social limits; or find yourself threatened with physical violence because of your partner's gender then shut the f**k up about your precious choice and freedoms - at least you have them, many of us don't. And asking to be treated as an equal citizen of any country, with all the rights and responsibilities thereof, has got nothing to do with trying to control or restrict your freedom. I'm sure you'll still retain the right to go to titty bars and puff out your manly chest whilst bench pressing Buicks to impress ze ladies.

*runs pride banner up the nearest flag pole*

 

[erg923]

Well, all this talk about silly political beliefs is turning me off. Snore. Although Tri's position of keeping those pesky gays down was entertaining. Happiness for some, but not for others. Just the attitude I want in my attending psychiatrist.

 

[nancysinatra]

Im sure seeing couples in loving relationships is hard for you, yes.

Can we please not turn this forum into a therapy session?

 

[erg923]

Can we please not turn this forum into a therapy session?

Unless, I'm being paid, its not. I assure you.

 

[nancysinatra]

I think you guys are unfairly ganging up on Vistaril. I think it's questionable behavior for one member to announce they've found another member's identity, and then for a bunch of people to jump on how that person has characterized themselves, without at the same time revealing an equal amount of information about their own identities.

People lie on the internet all the time. Its common practice! I have lied about specifics of my education and training on this forum, so that I can complain about med school and residency without risking being found out. From now on I think I will be more careful though, since I wouldn't want to end up being "blackballed" one day somewhere in the real world because people here don't agree with my views.

When I read anyone's post here, if they offer alleged "details" about their whereabouts etc, I assume they're false. I don't consider that "lying" - and certainly not lying on the level of falsifying military service! Anyone who has even heard of "match.com" let alone "craigslist" knows that people lie about themselves ALL the TIME on the internet. If you guys are coming here expecting forthright candor right down to identifying features then you are all just weird.

The views Vistaril is espousing in this thread are common in the general population. So why do they bother so many on this forum?? Vistaril's claim doesn't bother me, not really, even if I don't agree with all of it. He states his views calmly and never claims that the rest of you need agree. Now that post by "Tris" up above, that was creepy. We can always get more of that around here if people don't like vistaril's version of dissent.

Could it just be that there is some truth to Vistaril's characterization of psychiatrists as being a rather emasculated lot? If it's true it probably describes any number of modern day American white collar professionals.

In my view, even many of the women in psychiatry line up on the feeble, weak, overly agreeable end of the human spectrum. There's inherently a reason all these people chose careers where we sit around and listen to sob stories and offer people Kleenex. So what's the issue?

And why does it bother people so much that Vistaril criticizes psychiatry? Is criticism not tolerated in psychiatry? Is that the issue?

 

[erg923]

The views Vistaril is espousing in this thread are common in the general population. So why do they bother so many on this forum?

Because he is a practicing mental health physician, and I worry that some of his more extreme views: 1.) are simply in-congruent with some of the more essential elements of this profession (e.g., accurate empathy, cultural competence and sensitivity, establishing intimate interpersonal relationships). 2.) could easily spill over into his clinical work and clinical judgment/decision making, thus hurting patients.

Lastly, I really don't care if it is common in the general population or not. I generally feel morally obligated to stand against/counter opinion that is likely to cause social injustice. This is how I was raised in my community. This is how I raise my children.

I do agree that he maintains composure when presenting is opinions. I alos agree that one can have some pretty extreme opinions and have it not impact their clinical work. I do not feel confident that V has the insightfullness or training to do this, however.

 

[deleted314290]

Congratulations. This thread has perpetuated the stereotype of the crazy psychiatrist.

 

[nancysinatra]

Congratulations. This thread has perpetuated the stereotype of the crazy psychiatrist.

I don't think you need a thread for that purpose.

 

[Doctor Bagel]

I think you guys are unfairly ganging up on Vistaril. I think it's questionable behavior for one member to announce they've found another member's identity, and then for a bunch of people to jump on how that person has characterized themselves, without at the same time revealing an equal amount of information about their own identities.

People lie on the internet all the time. Its common practice! I have lied about specifics of my education and training on this forum, so that I can complain about med school and residency without risking being found out. From now on I think I will be more careful though, since I wouldn't want to end up being "blackballed" one day somewhere in the real world because people here don't agree with my views.

When I read anyone's post here, if they offer alleged "details" about their whereabouts etc, I assume they're false. I don't consider that "lying" - and certainly not lying on the level of falsifying military service! Anyone who has even heard of "match.com" let alone "craigslist" knows that people lie about themselves ALL the TIME on the internet. If you guys are coming here expecting forthright candor right down to identifying features then you are all just weird.

The views Vistaril is espousing in this thread are common in the general population. So why do they bother so many on this forum?? Vistaril's claim doesn't bother me, not really, even if I don't agree with all of it. He states his views calmly and never claims that the rest of you need agree. Now that post by "Tris" up above, that was creepy. We can always get more of that around here if people don't like vistaril's version of dissent.

Could it just be that there is some truth to Vistaril's characterization of psychiatrists as being a rather emasculated lot? If it's true it probably describes any number of modern day American white collar professionals.

In my view, even many of the women in psychiatry line up on the feeble, weak, overly agreeable end of the human spectrum. There's inherently a reason all these people chose careers where we sit around and listen to sob stories and offer people Kleenex. So what's the issue?

And why does it bother people so much that Vistaril criticizes psychiatry? Is criticism not tolerated in psychiatry? Is that the issue?

I overall agree that Vistaril gets picked on unfairly on SDN. I think Vistaril does engage in a bit of trolling, too, though, not to say that entirely justifies the level of negativity he gets. I could add a lot of thoughts about why this all happens but then I guess I'd be falling into a psychiatrist stereotype. I agree that threatening to out anybody is pretty serious, and outing is something we should avoid on this forum. I'm a person who stupidly revealed too much about where I am, and it's something I really regret, especially because I'm not a super cheerful person who just loved all of my experiences in training and in psychiatry.

About criticizing psychiatry (OK, maybe I'm getting a little psychological here), I think lots of us are on the border of being entirely demoralized in our work because our treatments don't work that well, our patients often don't get that much better, and we're forced to work in settings where we feel like we can't deliver effective care. Or maybe I should just speak for myself because perhaps most other people in the field feel like we're really delivering objectively effective care most of the time, and I'm either too nihilistic or depressive in my outlook. Admittedly I'm also currently working in a niche of psychiatry with a huge treatment failure rate, so that might color my perspective right now.

 

[hamstergang]

I think you guys are unfairly ganging up on Vistaril. I think it's questionable behavior for one member to announce they've found another member's identity, and then for a bunch of people to jump on how that person has characterized themselves, without at the same time revealing an equal amount of information about their own identities.

People lie on the internet all the time. Its common practice!

Vistaril represented himself as having more and better training in order to give more credence to his arguments. That isn't lying for anonymity. It's disrespectful to us and insecure for himself.

Plus, most of us just don't give details of our training. He chose to mislead instead of remain anonymous.

 

[billypilgrim37]

I know expecting people to read correctly is silly on an internet forum, but I never threatened to out him, would NOT out him, and have been plenty open about where I am. NDY pointed out previously why some of us think his lying was particularly crap.

 

[splik]

this is not really an anonymous forum. most of the regular posters are easily identifiable. i have received pms from people where they have referred to me by my own name or who claimed to have met me!

This thread is ridiculous. And yet despite the farce of novopsych frothing at the gash over vistaril, vistaril emasculating an entire race, tris lamenting the triumph of the "gay agenda" and the "homosexualization" of society, I can't help but think the most ridiculous comment on this thread was "What's wrong with Rand Paul?"

What's wrong with Rand Paul?

 

[notdeadyet]

This thread has officially followed the Vistaril arc to a tee: big provocative announcement to raise the ire of a large part of the readership (male psychiatrists and their lack of masculinity), his defense in which he basically raises the ire of others (women and their place), offhandedly comments to provoke other smaller groups (homosexuals, Indians, etc), then the thread always manages to winnow down to Vistaril's integrity (sic), politics, and all the rest. Hitler didn't get brought up yet (score!), but I am done playing my part in this little piece of drama. Against my better judgment again, dammit! Signing off humbled...

 

[Leo Aquarius]

This thread has officially followed the Vistaril arc to a tee: big provocative announcement to raise the ire of a large part of the readership (male psychiatrists and their lack of masculinity), his defense in which he basically raises the ire of others (women and their place), offhandedly comments to provoke other smaller groups (homosexuals, Indians, etc), then the thread always manages to winnow down to Vistaril's integrity (sic), politics, and all the rest. Hitler didn't get brought up yet (score!), but I am done playing my part in this little piece of drama. Against my better judgment again, dammit! Signing off humbled...

now you see why I keep eating popcorn and recommend others to follow...

 

[AnnoyedByFreud]

Well most guys in a marriage still in the prime of their life want to have a frequent and satisfying sexual relationship with their wife, for example. Look yo the nyt article/study just 6 or so months ago that made headlines- the gist is that domestic servitude makes a guy undesirable in the eyes and loins of his woman. For all your ranting, I am confident all these blue pill guys vacuuming aren't real happy to know that their wife doesn't respect them and doesn't want to sleep with them.

oh my god. You're a TRPer! So many things make sense now.

 

[vistaril]

Wanting "the most freedom for everyone" with the caveat "as long as it doesn't bother me" is right up there with having your choice of any color car as long as it's black. Might want to read up a lot more about Libertarianism before you start throwing the label around...

Should have stated as long as it doesn't interfere with my freedoms(and forcibly confiscating my money counts)....but yeah the initial language wasn't the tightest.

 

[vistaril]

I know expecting people to read correctly is silly on an internet forum, but I never threatened to out him, would NOT out him, and have been plenty open about where I am. NDY pointed out previously why some of us think his lying was particularly crap.

Billy, you are more than welcome to out me, whatever that means. I already self censure my postings on Internet forums to leave out any information I wouldn't want made public. Heck I'm at the furnace right now in birmingham, al and I'll buy any sdner a free lap dance if anyone is in the area....

 

[vistaril]

Because he is a practicing mental health physician, and I worry that some of his more extreme views: 1.) are simply in-congruent with some of the more essential elements of this profession (e.g., accurate empathy, cultural competence and sensitivity, establishing intimate interpersonal relationships). 2.) could easily spill over into his clinical work and clinical judgment/decision making, thus hurting patients.
.[/QU

Just because you don't agree with something doesn't mean it is extreme. My supposedly more extreme views on some of these matters are actually pretty much middle of the road(some would even say too liberal or leftist)when viewed outside of this bubble....

 

[erg923]

That doesn't really addres the concerns I expressed though, right? Cultural sensitivity, empathic abilities, etc.

 

[erg923]

And I dont really view the frequenting of strip clubs as inherently incongruent with the the work, just to be clear (although I do wonder what that's about?) Thats purely a person scruple that I happen to feel strongly about, so no worries there.

 

[vistaril]

That doesn't really addres the concerns I expressed though, right? Cultural sensitivity, empathic abilities, etc.

I guess not...but I'm not sure where you are getting the empathic ability or cultural sensitivity deficits from. The staff where I work a few days a week now are always commenting on how I'm spending so much more time per pt than the last person they brought in-I tell them that is empathy time

 

[xlithiumx]

I guess not...but I'm not sure where you are getting the empathic ability or cultural sensitivity deficits from. The staff where I work a few days a week now are always commenting on how I'm spending so much more time per pt than the last person they brought in-I tell them that is empathy time

You gotta find out the best strip clubs from somebody. May as well be patients. Amirite?

 

[vistaril]

You gotta find out the best strip clubs from somebody. May as well be patients. Amirite?

Well sure, but most cities my size only have a few different places....they are also heavily racially segregated. White guys go to the furnace or Sammy's and black guys/girls go to some other places on the north side

Atlanta is where the much better places are, but that is over 2 hours away

 

[erg923]

I guess not...but I'm not sure where you are getting the empathic ability or cultural sensitivity deficits from. The staff where I work a few days a week now are always commenting on how I'm spending so much more time per pt than the last person they brought in-I tell them that is empathy time

Your post history. And why are you equating time per patient with a skill competencey like accurate empathy? That doesn't even make sense?

 

[Mad Jack]

Being a real man is more about mindset and approach than anything else. No idea if you can out arm wrestle me(I actually don't track down/look up personal info and pics of other posters in forums like this but to each their own), but if we actually did arm wrestle and I was beaten, it would be shameful and I would work to improve on that. That's what made the original comment from a coworker I noted so shameful- not simply that his young daughter could out arm wrestle him, but that he thinks it is cute and can talk openly about it with relative strangers. That is the terrible part.

Right now I'm working 60 percent in mental health and 40 percent pursuing my passion of home remodeling, repairing property, and then real estate secondary to those things......it's going to take a heck of a lot of work to succeed in the property business because it's incredibly competitive, but being around men who act like men is the biggest difference by far between the two.

Men who are obsessed with manliness tend to be the biggest losers out there. A real man doesn't give a ****. That you are so obsessed with masculinity shows that you have some serious insecurity relating to your own manliness, like you're out to prove something or whatever. You think roughnecks and construction workers sit around pontificating about their own manliness?

 

[billypilgrim37]

Your post history. And why are you equating time per patient with a skill competencey like accurate empathy? That doesn't even make sense?

I actually appreciate that v did make a big point of protecting how much time he would be able to spend with patients in his job negotiations, and as I remember he took a decent pay cut for it. And yeah, that doesn't guarantee anything, but it probably means something.

 

[vistaril]

I actually appreciate that v did make a big point of protecting how much time he would be able to spend with patients in his job negotiations, and as I remember he took a decent pay cut for it. And yeah, that doesn't guarantee anything, but it probably means something.

Of all the problems in community psychiatry, the biggest(by far) from my perspective is that many pts view psychiatrists as simply people who write scripts in very brief and meaningless encounters...and honestly, a lot of times the pt is right.

Taking extra time to listen to the pt talk about some drama in his/her life....a cheating gf, an ex who won't pay child support, a kid who failed algebra......listening probably won't change my mgt in the outpt med check setting(Zoloft is Zoloft) but I think what pts most want is to be heard...they want to feel that their psych is willing to listen to what they care about.

It's going to cost some money to practice that way, so that's a decision every community psych has to make IMOIMO

 

[nancysinatra]

Because he is a practicing mental health physician, and I worry that some of his more extreme views: 1.) are simply in-congruent with some of the more essential elements of this profession (e.g., accurate empathy, cultural competence and sensitivity, establishing intimate interpersonal relationships). 2.) could easily spill over into his clinical work and clinical judgment/decision making, thus hurting patients.

Lastly, I really don't care if it is common in the general population or not. I generally feel morally obligated to stand against/counter opinion that is likely to cause social injustice. This is how I was raised in my community. This is how I raise my children.

I do agree that he maintains composure when presenting is opinions. I alos agree that one can have some pretty extreme opinions and have it not impact their clinical work. I do not feel confident that V has the insightfullness or training to do this, however.

Thanks for responding. I can especially appreciate your second point. I mean, if you disagree you disagree. I guess I would respond by saying that I don't think vistaril's views in this thread are "extreme." In fact, having lived outside the US, I find his views in this thread pretty tame. Many countries have far worse problems with machismo than the American form he is promoting! (In Northern Europe, such as Scandinavia, his views on gender would be ridiculed as outmoded for sure, but so would a lot of other ideas bein mentioned here, and in most other places he'd be far from alone.)

Plus even the idea that monogamy is superior to the alternative (strip clubs, playing the field, etc.) is a reflection of current American culture. 40 years ago you guys would have been scorning monogamy and promoting "free love," and Vistaril would have been bemoaning the death of the institution of marriage.

Regarding stopping what you believe to be social injustice, do you feel that only people who share your views about what is socially just should be trusted to provide mental health? If not, how would you accomodate for those providers who hold radically different worldviews from your own? In your view, for example, could a female Muslim who dresses fully covered in abaya and headscarf and is openly conservative in her social views be trusted to provide empathic, competent mental health care at a place like the VA?

As far as ensuring that Vistaril or anyone else here is clinically competent, don't you think that's the job of residency programs, the ABPN and state medical boards? I don't think we can conclude much about the skills of anyone here just from their opinions and writing style. I don't think it's wise to try, either. People can be one way on the internet and another way in person. Plus, most providers are not on this forum at all and it seems unfair to target those who are with an added later of "scrutiny."

At least those are my thoughts...

 

[Ceke2002]

... and then for a bunch of people to jump on how that person has characterized themselves, without at the same time revealing an equal amount of information about their own identities.

People lie on the internet all the time. Its common practice!

When I read anyone's post here, if they offer alleged "details" about their whereabouts etc, I assume they're false. If you guys are coming here expecting forthright candor right down to identifying features then you are all just weird.

I don't know enough about Vistaril's identity or claims of identity to give an opinion one way or another, so I didn't in that regard; however as BillyPilgrim rightly pointed out there was no attempt to 'out' Vistaril's identity, just some legitimate questioning of Vistaril's claims for preserving anonymity juxtaposed against his actual track record of information revealed.

And just for the record, seeing as the issue has been bought up, I'm not going to speak for anyone else on here, obviously, but I am more than happy to answer any queries regarding my identity or any of the identifying information I may have posted to this forum, so long as it doesn't contravene the forum's TOS. The only thing I won't reveal is my Psychiatrist's identity (not mine to give), or my private contact information.

And yes people lie on the internet all the time, but it would seem to me to a tad inept for someone to attempt to misrepresent themselves on a forum like this, when you have people who actually work in the field, who more often than not either know of each other as fellow medical practioners, or at least know people who study/work at the same institutions/programs that a person is claiming to have attended. I mean I could have come on here and pretended I was a Psychiatric Registrar, but how long would it have taken for people to call BS on my act?

 

[Ceke2002]

Well sure, but most cities my size only have a few different places....they are also heavily racially segregated. White guys go to the furnace or Sammy's and black guys/girls go to some other places on the north side

Atlanta is where the much better places are, but that is over 2 hours away

OT: Just as a point of interest did you know most girls in these establishments will continue working right up to full frontal, spread eagle nudity even during their menstrual cycle? Stripper's trick, you just make sure you insert a fresh tampon before the show, and tuck the string out of sight. Depending on the establishment (and the place I worked at was one of the more upmarket ones in my city) you can usually expect 50% of your earnings will go the House, and the House needs to make money so you're expected to find ways around slightly inconvenient issues like "I happen to be currently bleeding out my vag". Keep that in mind next time a girl's grinding her crotch a few inches away from your face, but do continue to enjoy.

 

[splik]

I'm not a mainstream conservative, and regard mainstream social conservatives as naive and ineffectual at best. You probably have a whole host of incorrect assumptions about me. I don't think homosexuality is an illness in the conventional sense, nor do I have any particular reason to think it can be cured or prevented. My position is not that we should seek to eradicate homosexuality, but simply that homosexuality should be kept "in the closet" as it used to be. If that means homosexuals aren't quite happy, oh well, sucks to be them.

I should know better than to reply but it does irk me that there are psychiatrists who would argue this nonsense. There are still vast swathes of this country where homosexuality is as you put it largely "in the closet" and there are many men who continue to live on the DL. They tend to be at higher risk of mood and anxiety disorder, substance use disorders, and sexually transmitted diseases, especially HIV and syphilis. Those gay men who stay "in the closet" as it were tend to do engage in more risky sexual behaviors and less likely to seek testing for STDs etc. Also those areas where the ratio of syphilis cases for M:F is closer together tend to be areas where more men are "in the closet" and thus giving syphilis to their wives and girlfriends - see Hamilton County, OH, Bexar County, TX, Tarrant County, TX, and Hilsborough County, FL - which have the very similar numbers of men and women with syphilis and also tend to have a lot of anti-gay sentiment. The latter for example banned gay pride several years ago.

"aren't quite happy" - doesn't come close. There are people so tortured about their sexual orientation they just want to die, they experience significant self-loathing, isolation, aloneness and pain which often leads to the kind of risk behaviors that people who don't care about themselves develop. Most of my patients are gay and keeping homosexuality "in the closet" is what cultivated this sense of otherness they have that is often related to much of the psychopathology I see.

 

[Ceke2002]

I should know better than to reply but it does irk me that there are psychiatrists who would argue this nonsense. There are still vast swathes of this country where homosexuality is as you put it largely "in the closet" and there are many men who continue to live on the DL. They tend to be at higher risk of mood and anxiety disorder, substance use disorders, and sexually transmitted diseases, especially HIV and syphilis. Those gay men who stay "in the closet" as it were tend to do engage in more risky sexual behaviors and less likely to seek testing for STDs etc. Also those areas where the ratio of syphilis cases for M:F is closer together tend to be areas where more men are "in the closet" and thus giving syphilis to their wives and girlfriends - see Hamilton County, OH, Bexar County, TX, Tarrant County, TX, and Hilsborough County, FL - which have the very similar numbers of men and women with syphilis and also tend to have a lot of anti-gay sentiment. The latter for example banned gay pride several years ago.

"aren't quite happy" - doesn't come close. There are people so tortured about their sexual orientation they just want to die, they experience significant self-loathing, isolation, aloneness and pain which often leads to the kind of risk behaviors that people who don't care about themselves develop. Most of my patients are gay and keeping homosexuality "in the closet" is what cultivated this sense of otherness they have that is often related to much of the psychopathology I see.

I could seriously hug you right now. Everything you have said here is truth personified. I was at least 6 when I first began to realise I had an attraction to both genders, albeit from a child's point of view regarding attraction, by the time I was in my teens those feelings hadn't gone away so obviously it was becoming increasingly clear that this wasn't some sort of passing phase. At that time I had no idea such a thing as bisexuality even existed, I had no idea what I was. I was attracted to women, I wanted to date women, so I must be gay, but then I'm also attracted to men, and I want to date men, so does that make me straight? I was so confused, and mixed up, I had no one to turn to or talk with, I tried to force myself into being something I wasn't from both sides of the equation (trying to be entirely gay or entirely straight) and it just made matters worse. All of this did nothing but to serve to exacerbate the existing mental health issues I already had, and probably created some of it's own along the way to boot. And then I met someone who had the same feelings as me, and who could articulate those feelings in a way that made me feel understood, and as if I was truly seeing a part of myself for the first time, and the sheer joy of relief and sense of freedom that it bought was almost indescribable.

The moment I came out the closet, almost 23 years ago now, was one of the most defining and freeing moments of my life, and I have no intention of ever going back.

 

[erg923]

Plus even the idea that monogamy is superior to the alternative (strip clubs, playing the field, etc.) is a reflection of current American culture. 40 years ago you guys would have been scorning monogamy and promoting "free love," and Vistaril would have been bemoaning the death of the institution of marriage.

Hippies/counterculture types were a minority of the population in this country, even at the height of their prominence. Many individuals, my parents included, never bought into free love or anything of the sort. So, no, I dont think my views are simply a product of the times.

Regarding stopping what you believe to be social injustice, do you feel that only people who share your views about what is socially just should be trusted to provide mental health?

Well, that's an empirical question, right?

If ones view is shown to have a significant negative impact on mental health in outcome literature, then yes, I would object to someone bringing that opinion into the room. See SPLIKs post on homosexuality for more details above. But I think that its quite obvious that some views on the nature of your fellow human being are simply in-congruent with the practice of psychiatry, since your job is to promote behaviors that are are know to improve mental health functioning, not hinder or harm it. There's not an admissions committee in this country that would admit Tri to their psychiatry residency program if he wrote that in one of his essays, right? Why is that? See my point above.

In your view, for example, could a female Muslim who dresses fully covered in abaya and headscarf and is openly conservative in her social views be trusted to provide empathic, competent mental health care at a place like the VA?

Not enough information provided here to answer your question. You would need to operational "conservative," as it means different things to different people. For example, is Pope Francis "liberal" or "conservative?"

I would again argue that if her views is that homosexuals need to "stay in the closet" (since we know the adverse effects this has on ones mental health and other health behaviors), then yes, I would have concerns about her. Similarly, if she advocated that her patients should conform to stereotyped gender behaviors/interests, yes, I would have concerns. Now, I doubt V does that explicitly in his professional duties, but I think it would be hard not to let such a black and white view of human nature "seep out" in some way.

As far as ensuring that Vistaril or anyone else here is clinically competent, don't you think that's the job of residency programs, the ABPN and state medical boards?

Not solely, no.

 

[erg923]

I actually appreciate that v did make a big point of protecting how much time he would be able to spend with patients in his job negotiations, and as I remember he took a decent pay cut for it. And yeah, that doesn't guarantee anything, but it probably means something.

Yes, this is good. And he has consistently rebelled against the attitude of volume (15 min med checks) vs quality and depth.

 

[Salpingo]

People lie on the internet all the time. Its common practice! I have lied about specifics of my education and training on this forum, so that I can complain about med school and residency without risking being found out. From now on I think I will be more careful though, since I wouldn't want to end up being "blackballed" one day somewhere in the real world because people here don't agree with my views.

When I read anyone's post here, if they offer alleged "details" about their whereabouts etc, I assume they're false. I don't consider that "lying" - and certainly not lying on the level of falsifying military service! Anyone who has even heard of "match.com" let alone "craigslist" knows that people lie about themselves ALL the TIME on the internet. If you guys are coming here expecting forthright candor right down to identifying features then you are all just weird.

While this has probably been beaten to death already, and I agree its good to have a healthy dose of skepticism on the internet, this isn't a dating website. The point is for people to give, and receive, advice on psychiatry. Deliberately misleading people (as opposed to not disclosing particular information) kind of renders this point moot, at which point this forum would just turn into random salary figures and people critiquing their own fantasy worlds (e.g. even though I'm a chief resident at a top Northeastern program, I can't find believe how much my fiancee is making and how I can't find anyone to talk about repairs on the slums I'm rebuilding).

Also, since we're discussing the virtues of the internet, its probably not a good idea to say anything that you wouldn't say to your PD or patient. I've seen so many people get burned assuming what they're saying is anonymous.

 

[Salpingo]

"aren't quite happy" - doesn't come close. There are people so tortured about their sexual orientation they just want to die, they experience significant self-loathing, isolation, aloneness and pain which often leads to the kind of risk behaviors that people who don't care about themselves develop. Most of my patients are gay and keeping homosexuality "in the closet" is what cultivated this sense of otherness they have that is often related to much of the psychopathology I see.

Thank you. And while I don't have much in the way of substance that you had to back up your claim, I can say that the opportunities to work with the marginalized and ostracized have been one of the most rewarding aspects of my job (and sounds like Vistaril's job as well). Outside of operating heavy machinery and bow-hunting, its what separates us from our baser instincts and people like ISIS. Please remember this: ISIS is the new Hitler.

Sorry to deviate from the original post, and to perpetuate this thread. As for the original question, why a specialty centered around talking about feelings doesn't attract more superficial machismo... well, that might just be an unanswerable question.

 

[touchpause13]

I just want to chime in and say that coming out of the closet was easily the most freeing, best things I've ever done for my own mental health. While I was in the closet I had severe anxiety, lost all self worth, and was suicidal. I don't like to talk about that much but it just pisses me off that anyone who is involved in mental health could suggest it's better to be in the closet and that gays in the closet are just a little bit unhappy. That's bullshet.

 

[Ceke2002]

I just want to chime in and say that coming out of the closet was easily the most freeing, best things I've ever done for my own mental health. While I was in the closet I had severe anxiety, lost all self worth, and was suicidal. I don't like to talk about that much but it just pisses me off that anyone who is involved in mental health could suggest it's better to be in the closet and that gays in the closet are just a little bit unhappy. That's bullshet.

Quoted for truth. It's stories like yours, and mine, and so many others out there that make me even more determined to remain openly and proudly out as a bisexual woman. Heck I'm so 'out' I might as well walk around with a flashing neon sign above by head LOL (well maybe not that extreme, but my orientation is an integral part of who I am and I refuse to be ashamed of it). Just personally when it comes to being faced with someone who is homophobic, there are obviously times when you can just tell that nothing you could ever possibly say or do would change the person's mind, but if I get a feel that perhaps there's even a glimmer in there somewhere that I can open a dialogue with someone and get them to reconsider their point of view, more often than not I will take the opportunity. It doesn't always work, but I've had a few successes here and there - one I'm particular proud of is a dialogue I had with a vocally forthright homophobe (the usual 'gays are perverted, it makes me wanna puke, it's disgusting, etc etc type attitude), who I ended up befriending and talking with for over a year...She is now an outspoken straight ally and volunteer activist for GLBTQI rights and she also ended up becoming one of my most beloved friends. Complete 180 turn around, it was so awesome to see, I'm so proud of her.

Unless you've been there yourself so few people will ever truly understand what it's like to have to go through the process of realising you're not exactly heterosexual, and just how much that can screw with your head. And then to have people in the Psychiatric profession not understand, or choose to willfully ignore all evidence to the contrary, and tell people to stay hidden - that is just, whoa total head shaker. I mean seriously...

 

[michaelrack]

"Real men" post identifying information on ananoymous Internet forums.

I agree.

 

[BobbyB]

the shift in job responsibilities is the reason there is a change in personalities in medicine

in the past, medicine was more autonomous. this attracted strong leaders.

now, we're all just a cog in the healthcare juggernaut. it is beneficial to be a weaker don't ask questions type of person.

 

[birchswing]

the shift in job responsibilities is the reason there is a change in personalities in medicine

in the past, medicine was more autonomous. this attracted strong leaders.

now, we're all just a cog in the healthcare juggernaut. it is beneficial to be a weaker don't ask questions type of person.

That's actually somewhat related to the primary theory on how wolves evolved into dogs. They developed pleasing behaviors that were less likely to frighten humans, so as to be able to live near civilizations. It's why they're so good at sitting around a kitchen table waiting for a scrap to fall. It's very cute when you think about it.

 

[fez68w]

Interesting turn of events for this topic.
This is so silly...

 

[birchswing]

Lord knows why, I guess I like the diversion, I started thinking of real-life examples of "real men" as defined by Vistaril's characteristics. Charlie Sheen came to mind as did Donald Trump.

If you're still here Vistaril, I would love if you could rank the following for us in order of real-manliest to least. These are just the men who came to me—feel free to add your own.

Various well-known people who identify as male (to my knowledge):
Charlie Sheen
Donald Trump
Stephen Hawking
Richard Branson
Tiger Woods
Michael Sam
Chaz Bono
Tom Cruise
George Clooney
Rock Hudson
Howard Stern
Tim Allen
Jerry Seinfeld
Pat Buchanan
Eckhart Tolle
Adolf Hitler
Jesus of Nazareth
Aristotle
Stephen Sondheim
Walt Disney
Michael Jordan
Magic Johnson
John Leguizamo
Barack Obama
Bill Clinton
George W. Bush
Dick Cheney
George H.W. Bush
Ronald Reagan
Vladmir Putin
Fidel Castro
Kim Jong Un