Brilliant, thoughtful critique of psychiatry

I have excerpted from a very long article from the Psychiatric Times, the below paragraphs. I strongly urge people to read the whole thing, but if you need a taste of what David Kaiser MD is saying read the below paragraphs. This is the best critique of psychiatry I’ve read from a practicing psychiatrist. It was written over a decade ago but the reality on the ground remains disturbingly exactly the same:

The purpose of this piece is not to attempt a full critique or history of this occurrence, but to merely present some of the glaring problems of this movement, as I believe significant harm is being done to patients under the guise of modern psychiatric treatment. I am a psychiatrist trained in the late 1980s and early 1990s, and I use both psychotherapy and medications in my approach to patients. I state these facts to make it clear that this is not an antipsychiatry tract, and I am speaking from within the field of psychiatry, although I find it increasingly impossible to identify with this profession, for reasons which will become clear below.

Biologic psychiatrists as a whole are unapologetic in their view that they have found the road to the truth, namely that mental illnesses for the most part are genetic in origin and should be treated with biologic manipulations, i.e., psychoactive medications, electroconvulsive treatment (which has made an astounding comeback), and in some cases psychosurgery. Although they admit a role for environmental and social factors, these are usually relegated to a secondary status. Their unquestioning confidence in their biologic paradigms of mental illness is truly staggering….

….So what are the limitations of biologic psychiatry? First of all, medications lessen symptoms, they do not treat mental illness per se. This distinction is crucial. Symptoms by definition are the surface presentation of a deeper process. This is self-evident. However, there has been a vast and largely unacknowledged effort on the part of modern (i.e., biologic) psychiatry to equate symptoms with mental illness…..

….It is an absolute myth created by modern psychiatry that these “disorders” actually exist as discrete entities that have a cause and treatment. This is essentially a pseudo-scientific enterprise that grew out of modern psychiatry’s desire to emulate modern medical science, despite the very real possibility that psychic pain, because of its existential nature, may always elude the capture of modern medical discourse and practice…..

…..What is left completely out, of course, are any notions that our psychic ills are a reflection of cultural pathology. In fact, this new biologic psychiatry can only exist to the extent it can deny not only the truths of psychoanalysis, but also the truths of any serious cultural criticism. It is then no surprise that this psychiatry thrives in this country presently, where such denials are rampant and deeply embedded….

….Patients these days are not suffering from “biologic illnesses.” What I generally see is patients suffering from current or past violence, traumatic loss, loss of power or control over their lives and the effects of cultural fragmentation, isolation and impoverishment that are specific to this culture at this time. How this manifests in any individual is absolutely specific; therefore, one should resist any attempt to generalize or classify, as science forces us to do. Once you go down the route of generalization, you have ceased listening to the patient and the richness of their lived experience. …..

…..Having said this, what I am advocating is a psychiatry which devotes itself humbly to the task of listening to patients in a way that other medical practitioners cannot. This means paying close attention to a patient’s current and past narrative without attempting to control, manipulate or define it. From this position a psychiatrist can then assist the patient in raising relevant questions about their lives and pain.

The temptation to provide answers or false solutions should be absolutely avoided here. Medications are used judiciously for lowering painful symptoms, with considerable attention paid to the psychological effects of medication treatment. Diagnosis should play a secondary and small role here, given that little is known about what these diagnoses actually mean. Above all suggestion, coercion, normalization and control need to be assiduously guarded against, as these are natural temptations that arise out of the dynamics of power that exist between psychiatrist and patient.….(emphasis mine)

Read the whole awesome and profoudly thoughtful critique here.

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