The other side of the fence: Iatrogenic stigma.

I found the below article quite thoughtful and well done. It’s in keeping with what I learned when I worked in the system as well. I’ve written about this issue quite a lot. I’m sorry the British Journal of Psychiatry denied it, but we can help pass it about this way.

I like how the author underscores that professionals need to tend to their own bigotry first which is something I write about often. The systematic “othering” of service users is toxic and certainly a cause of psychological and spiritual iatrogenic injury. I go so far as to consider that as human beings trying to figure out what the heck we’re doing here on this planet we are all peers, service users and professionals alike. This doesn’t sit well with everyone in the peer movement either, but as a suggestion to contemplate I believe that it eradicates any sort of hierarchy at all and for that reason deserves consideration. You can read my thoughts on the topic here: Mental health-related stigma in health care and mental health-care settings: response to journal article

Hole Ousia

This is an Editorial that I submitted to the British Journal of Psychiatry. It was rejected for the following reasons:

MS ID#: BJP/2012/115832

The strengths of this paper are:

  • It discusses an important set of issues ie how far psychiatric staff themselves contribute towards stigma

The limitations of the paper are:

  • It takes a rather anecdotal approach eg a colleague of mine recently wrote etc
  • The paper does not seek to examine the evidence that stigma more generally, or more specifically within the psychiatric profession, are getting better or worse
  • The paper tends to go over old ground somewhat eg in rehearsing definitions of stigma
  • The literature review is rather patchy ie citing the Angermeyer review on biological causal explanations of mental illness but not the recent Schomerus paper
  • The discussion is rather wide ranging eg referring to ‘herd instinct’ and Kierkergaard etc
  • There is a fairly substantial literature on mental…

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The Nourishment Model of Counseling

Though most counselors do not use these early Freudian psychoanalytic theories in their practice, they still use much of the same structure for helping people to heal. Conversations are limited to specific periods of time, are usually done in an office setting and generally focus on examining personal experience and looking towards restructuring thoughts and beliefs and making personal changes to improve life. Though counseling in this way can often be deeply helpful, I think we have become excessively focused on the cognitive approach to healing people in emotional distress. Instead of a cognitive based approach, I think we should place much more focus on somatic “body-based” counseling. Often times I hear people complain that people would rather go to a doctor for psychiatric medication than go to a therapist. Part of this has to do with the idea that it is easier to simply take a medication than engage in therapy, but part of the reason is because medication actually causes immediate physiological changes and affects how one feels and thinks by affecting the nervous system. People who are in distress are often looking for a way to alleviate that distress and talking about it does not generally produce that alleviation they are looking for. … [click on title for the rest of the post]

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