Doctor Munchausen, I Presume!

107
398

As Britain descends into an orgy of handwringing about the abuse of vulnerable people, this is the first of several posts by David Healy to tackle the issue

In 2000 when I gave a lecture on “Psychopharmacology and the Government of the Self” at the invitation of the University of Toronto, I ran into a problem.  In the public domain our shared difficulties were because of this lecture.  In fact, the difficulties stemmed from a member of the Establishment – Charlie Nemeroff – who put the frighteners on the U of T about hiring Healy.

‘The psychopharmacology establishment in the face of adverse effects from drugs’ is the same as ‘the medical establishment in the face of treatment-related adverse effects’ is the same as ‘the British establishment in the face of allegations of paedophilia and child abuse’ is the same as ‘the Vatican in the face of allegations of abuse.’

It’s about power.  We have it – you don’t.  Get lost.

There is maybe a difference in that it could be argued that academics are just middle men these days, rather than holders of real power – but sometimes the less power the more vicious and nasty the abuse.

Psychopharmacology and the Government of the Self

The lecture had twenty-six slides, of which all, bar one, were images.  It can be accessed HERE.

The main point was that the face of medicine was changing.

At the heart of this change was the fact that drug development now went through clinical trial programs and the data from these trials were now hidden.  Because of this we were in an increasing darkness about the hazards of treatment.  Not just specific hazards but the very idea that there might be hazards was being lost.  There was no way to keep a check on things.  This was a call for access to clinical trial data long before AllTrials or Tamiflu were heard of.

The lecture was widely misreported as ‘Healy said SSRIs cause suicide.’  The message was that I believe SSRIs cause suicide, you in the audience likely don’t – the difference stems from the fact that you haven’t seen and cannot get to see what I have seen.

Against this background conflict of interest was an issue of growing importance – we were increasingly dependent on the people we might turn to if things went wrong – the police in the case of abuse, bishops in case of clerical abuse, academics in the case of pharmacological abuse – or perhaps members of a Hospital or Health Board.

As a way to illustrate the point, one of the 26 images used was that of Harold Shipman.  Shipman was a doctor whose case was then dominating the headlines of British and world medical care.  He had murdered hundreds of his patients, mostly women.  There seemed to be some gain in terms of getting their wills altered so he was given money, but no-one believed this was enough to explain what had happened.  He seemed to enjoy it.

We were, I said, creating conditions in which Shipmans could flourish.

From Hero To Villain

Baron von Munchausen was a real life eighteenth century German, a colorful character who traveled widely and developed a reputation for tall tales.  There was nothing wrong with his health – physical or mental.  But he has posthumously been done in.

In 1951, a British doctor describing three cases of patients who were feigning illnesses behind the smokescreen of colorful stories suggested describing this condition as Munchausen’s Syndrome.  The patients were thought to be trying to pass themselves off as ill in order to gain attention or sympathy.  The Baron, as a result, is probably now thought by most people who hear of Munchausen’s Syndrome as someone who was mentally ill.

In the mid-1970s a new disorder emerged – Munchausen’s Syndrome by Proxy.  In this case parents were thought to be making their children ill, in some cases close to killing them, in order to gain medical attention.

Proxy Munchausen’s has given rise to huge controversy.  There was a rush to label parents in cases doctors found difficult as sufferers.  Some of the parents fought back and won.  The reputations of several leading doctors who had branded parents injudiciously were destroyed.

Everyone agrees that the original syndrome is pretty rare and the proxy variant is even rarer – I may have seen one convincing case of the proxy syndrome in my career.

The Dynamics of Abuse

But just as Tall Tales take on a life of their own, the idea of Munchausen’s syndrome has penetrated deep into healthcare.  It seems to shape shift as it goes.  Mental health workers now faced with an awkward patient protesting that the treatment they are on is not suiting them bizarrely describe these “awkward” people as suffering from Munchausen’s, with an awkward mother complaining about the treatment her son is being put on being labeled Munchausen’s by Proxy .

This is exactly the opposite to the original syndrome. In this case people with a real illness, who are being given a very real second problem, are being termed fantasists.  Why?

With all abuse, dynamics come into play.  In the case of priests, or Britain’s most famous abuser Sir Jimmy Saville, the sheen of good works makes it almost impossible for others aside from the victim to see the dark side.  It’s just difficult to hold two contradictory things in our mind at the same time.

In medicine, blaming the patient or a relative is the perfect way to hide the identity of the real abuser – the doctor.

Doctor Munchausen is not an uncommon figure.  He or she is the one who gives you illnesses which they then feed off of.  There is one – likely several – working in every hospital in the land – from Bangor in Wales through to Sydney in New South Wales, from Seattle to Dr Nemeroff’s new stomping ground in Miami, from Vancouver to Halifax, from Belo Horizonte – where the dream died – to Buenos Aires where Jorge Mario Bergoglio comes from.  Europe is stuffed full of them from Helsinki through Berlin to Lisboa.

The Mechanism of Abuse

The mechanism of abuse is very PC – a prescribing cascade.  When a problem develops on treatment you are put on more of the same treatment or further drugs are added to treat the original problem and unless you have a lucky escape or have extraordinary courage the abuse keeps going until you are dead. Doctors who abuse are concealed by the fact they are doing even more of what good doctors do than their colleagues are doing.

Caught like a child in the soft fleshy hands of a priest, it’s almost impossible to escape.  No-one will believe you – not the doctors’ colleagues, not the management of a Hospital – especially if the abuser is one of them – not any of the regulatory bodies in health nor the government.

It’s difficult to know whether the mental health system is worse than the rest of healthcare.  Here the abuser has the power to forcibly detain a perfectly normal person in hospital who might for instance be suffering a very clear physical reaction to treatment and threaten them with shock therapy.  One Flew Over the Cuckoo’s Nest is not something that happened back then – it happens today and will happen tomorrow and tomorrow and tomorrow in mental healthcare but typically with antipsychotics rather than ECT.

There seems to be no protection.  This can happen in hospital settings where the boss may have once have been responsible for making sure that vulnerable patients are not abused by the Mental Health Act.  Once a person with this kind of background swaps sides and becomes part of the system and it’s a case of stopping a person who sits across the table from them from abusing someone, they seem unable to do it.  The abusers are Welt-Meisters – Masters of their little Universes.

Descent into Hell

Following Shipman, there was an orgy of efforts to make sure this couldn’t happen again. British doctors now have to be revalidated, regulatory bodies have more teeth, the checks are ever more thorough.  But all this does is to penalize the good doctor without in any way stopping or deterring the most profound abuse.  The abuser is now in fact even more protected by a battery of boxes ticked and forms filled . . .  If it is to survive the system cannot let them be fingered as abusive.

Last week, following revelations of pedophile rings operating at the highest echelons of British society, Britain began its descent into another orgy of hand-wringing: How do we stop the powerful doing these things?

The place on this earth where there is the greatest mismatch in power between two people is when doctors meet patients. The easiest place on this earth for an abuser to flourish is in a doctor’s office.  Have a look there.

* * * * *

This article first appeared on David Healy’s website,
DavidHealy.com

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

***

Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.

107 COMMENTS

  1. “Following Shipman, there was an orgy of efforts to make sure this couldn’t happen again.”

    Hi David,

    I quote the statement above because it has two meanings for me. the first is that the likes of Shipman (the only Doctor to EVER be prosecuted for murder) should never be allowed to happen again. Can’t be much abuse occurring if there’s only ever been one right?

    The second meaning for me is that the medical establishment need to make sure that no one is ever caught again. And that is what is happening, despite the increased accountability measures within the law. There is an appearance of protections, but they are simply not worth the paper they are written on. Those charged with the duty of enforcing the protections are simply ignoring them, and subjecting anyone with a valid complaint to further legal and administrative abuse.

    Make the victims disappear, and enable the abuser.

    I know one personally, who laughed when I said I was going to have him held accountable for his criminal behaviour. He was right to feel so confident that his abuse was being enabled, despite me not being the only person who had made formal complaint. The ‘gaslighting’ during the complaints process is highly effective, and would in many cases result in the victim either committing suicide, or requiring institutionalisation. Thus, as you point out, the best abusers will never be held accountable.

    I look forward to reading more of your articles

    Thank you
    Boans

    Report comment

    • “There is an appearance of protections, but they are simply not worth the paper they are written on.”
      Indeed, especially in the mental health system.
      The hospital I was abused in has a long history of abuse dating back to good old Nazi times and a streak of scandals from neglecting and abusing kids to the point of death, through people dying in restraints, setting themselves on fire to escape abuse, staff members coming out about the mistreatment of patients, and so on and so forth. And guess what – absolutely nothing’s changed, not even after media attention and committees meeting and UN conventions being signed and ratified. It looks lovely on paper and then the door closes and the ghost of Mengele appears.
      They know they’re never be held responsible so they do whatever they want.

      Report comment

    • “There is the appearance of protections, but they are simply not worth the paper they are written upon.”

      “Make the victims disappear, and enable the abuser,” is the name of the game in the US right now.

      I, too, have an example. The doctor who had me medically unnecessarily shipped a long distance to him, misdiagnosed me twice according to his hospital’s medical records, then had me “snowed” (to cover up prior easily recognized and confessed medical mistakes and evidence of the abuse of my child for the religion that owned the hospital he worked through, at the time), has now been arrested by the FBI for doing the same thing, and worse, to many other patients, resulting in many patients deaths. A little info on Dr. V R Kuchipudi:

      http://chicagoist.com/2013/04/16/chicago_hospital_owner_doctors_arre.php

      http://www.justice.gov/usao/iln/pr/chicago/2013/pr0416_01a.pdf

      This doctor is still practicing medicine. I initially filed a complaint against his psychiatrist partner, Humaira Sayied, and him with the IL Department of Professional and Financial Regulations in, I think, 2010. Then dropped off copies to the local FBI and Secretary of State, after I’d picked up proof my signature had been forged in medical records, and the court documents proving my civil rights had been taken away illegally.

      The case was initially ignored by the IL DPFRs. The case was never looked into by the FBI, unless they’ve neglected to offer me a whistle blower settlement – although there were lots of hints Kuchipudi was an over medicating doctor:

      http://projects.propublica.org/checkup/providers/1345809

      But the lawyer in the FBI case has yet to respond to my correspondence (although the FBI is claiming the hospital owner is the brain child of the Sacred Heart scam, possibly because he has Obama connections. But since Kuchipudi was doing the same thing at another hospital way back in 2006, the FBI could possibly be incorrect about who the actual mastermind is.). The States Attorney’s office bowed to the FBI, and totally ignored my concerns.

      So, once I’d learned of Kuchipudi’s arrest in 2013, I spoke with a Mr. Marion at the IL DPFR, he said he’d reopen the case. I spoke with someone last week who told me the case had been closed, without the IL DPFR doing anything, AGAIN, regarding this doctor whose now been arrested for similar and more egregious crimes against many.

      “There are the appearance of protections, but they are simply not worth the paper they are written upon.”

      “Make the victims disappear, and enable the abusers.”

      Report comment

  2. After reading this post, I am compelled to ask just one question of David Healy: if you already haven’t done so, when will you renounce your Medical Degree after writing that ending above:

    “The place on this earth where there is the greatest mismatch in power between two people is when doctors meet patients. The easiest place on this earth for an abuser to flourish is in a doctor’s office. Have a look there.”

    No, Mr Healy, the easiest place for an abuser to flourish, in order, is one’s home, one’s extended family, one’s business, and overtly of late throughout the globe, one’s political office.

    For every legitimate “abuser” you can document in a doctor’s office, I will be able to show you dozens masquerading as politicians, as business leaders, and “pillars” of the community at their home owner meetings/country clubs/PTA meetings.

    Again, thanks for the validation this blog is as antipsychiatry and antiphysician I have read since the garbage over at Thehealthcareblog.com.

    Here the rustle in the brush around this thread? And the attempt at feeding commences!!!

    Report comment

    • “For every legitimate “abuser” you can document in a doctor’s office, I will be able to show you dozens masquerading as politicians, as business leaders, and “pillars” of the community at their home owner meetings/country clubs/PTA meetings.”

      Like a prisoner exchange?

      Personally if I knew of any abusers I’d report them for free, not be looking to exchange them. And what is this, “there doing it too”.

      I look forward to the days when we are hunting down these abusers no matter where they are hiding, like the Mossad hunts war criminals.

      We won’t forget.

      Report comment

      • What passes as “discussion” at this blog is just pathetic. Where in god’s name did you twist my comment to a “prisoner exchange”? But, it isn’t about discussion, it is about unsubstantiated accusations and jamming all those sick psychiatrists into that hideous mold called mental health care by the Marquis de Sade, eh?

        I am going to keep coming back to this thread and take each and every one of you on until you either have a honest and respectful dialogue, or, the authors here will allow the shout downs be so persistent and ugly that it will define once and for all my accusations what this blog is about.

        Or, I’ll just be censored to make sure the agenda stays pure, hmm?

        Maybe the authors of the blog can give me the appropriate interpretation I was to alternately conclude from the above by “Boans”?

        Joel Hassman, MD

        Report comment

        • Boans was simply pointing out that pointing finger to somebody else and saying “but he has committed worse crimes” doesn’t exactly absolve you from responsibility for your own action.
          “Or, I’ll just be censored to make sure the agenda stays pure, hmm?”
          Well, in any case thank you for clarifying what your agenda is.

          Report comment

          • I didn’t get to respond to boans before your comment, so I’ll just comment here.

            Pointing fingers at others was not Dr. Hassman’s point at all. He responded to a somewhat overly melodramatic claim that when doctors meet patients it is the greatest mismatch in power between two people and the easiest place on this earth for an abuser to flourish.

            Dr. Hassman gave what he sees as other examples of this that are more prevalent and more unequal.

            I personally don’t believe Dr. Healy can back up his claim and that no one can substantiate the worst of either case, because quite honestly it varies.

            I recall the days when feminists were shrieking that the most unequal relationship was marriage. To make these kind of statements appeals to followers but doesn’t do much for an onlooker trying to decipher what is going on.

            Report comment

          • “I personally don’t believe Dr. Healy can back up his claim and that no one can substantiate the worst of either case, because quite honestly it varies. ”
            Well, apparently Dr Healy assumed that most people are able to distinguish rhetorical statements from factual statements. It’s something that I was taught to recognise in primary school during text analysis exercises… The sort of “what the author had in mind” – a very useful thing when you read…
            If you try to take every sentence of every article literally then you end up with nonsense.

            Report comment

          • I’ve read almost the same statement in comments on psych boards and they mean it literally. For those, it may even be true in their own lives.

            Dr. Healy writes good prose. But I’d say the subject doesn’t need rhetoric; it is serious enough on its own.

            Report comment

          • “But I’d say the subject doesn’t need rhetoric; it is serious enough on its own.”
            Maybe it doesn’t but it a question of style of an author and personal preference of the reader while looking for one or two phrases like that in an article and pretending (?) that you understand them literally and point to them as deliberate lies or inexcusable errors is in my view a manipulation tactics. Unless of course someone’s text comprehension skills are really poor.

            Report comment

        • Looks to me as though Boans was engaging in some lateral thinking and riffing on “for every X I’ll give you Y” (i.e. exchange).

          While I’m translating, it looks like “take each and every one of you on” was meant as an invitation to honest and disrespectful dialogue, yes?

          Report comment

          • That is fine but it wasn’t his point. Dr. Hassman is speaking of prevalence of abusers not exchange.

            Everyone has the choice to be disrespectful or not. It does not depend on your opponent, and it does not depend upon the argument. Make your own choice.

            I will tell you that on this blog I saw one of the most childish displays of disrespect ever on a blog. I very much appreciated that they deleted the comments.

            Report comment

          • Well, that is your interpretation, but, I would be interested in NON blog authors or other commenters who do not have direct benefits from this blog to tell me where I was asking for an alleged type prisoner exchange in the above comment.

            So far, only one person to respond to me has been honest and respectful, so I guess Ms Mead you are right on that point, the others are being honest, and disrespectful. And I won’t have my hands tied behind my back to engage in a verbal knife fight most of the participants here want demanded of physicians.

            I advise readers who are fair and impartial to read up on Saul Alinsky and see if his tactics fit the narrative of the usual dialogue of these threads that have any physician input.

            You might be surprised I may have a legitimate perspective. When people are shooting figurative rockets at you, you don’t just sit down and say “let’s talk about it”, unless you enjoy being blasted endlessly.

            No, the antipsychiatry dialogue does not gain kind, pleasant responses anymore, I learned that lesson at Furious Seasons.

            When in Rome, Ms Mead?…

            Joel Hassman, MD

            Report comment

        • Oh. It’s you.

          If you’re looking to get your butt kissed, Joel Hassman, MD, then you’ve come to the wrong place. No one died to make you our master. Almost every comment I’ve ever seen you make has been juvenile and emotionally overwrought.

          Step off.

          Report comment

          • Is this the same Wiley at 1boringoldman.com who wakes up some mornings wanting to pistol whip Freud, or the nearest facsimile that is an active living psychiatrist you think wronged you of late?

            If you are, maybe entertain the masses what you dream of doing to me, and have the intestinal fortitude to share it with the blog, so your outstanding management skills will surely shine brighter than mine.

            If you aren’t, my sincere mistake, but, I never spoke of asking to be master and having my butt kissed, but I’ll go out on a limb and suggest you might be projecting your wants and expectations onto me so I can maintain that defacto villain role you and the other antipsychiatrists crave so eagerly.

            Step off, what, the cliff so I can fulfill some twisted fantasy I help the usual suspects envision that psychiatry won’t exist anymore? yeah, I read that beauty by another commenter here a month ago.

            Time to move onto the next feeder…

            Oh, and I see me being censored while the other attacks stay in place. Gee, like the Hamas analogy I believe fits more and more from posts like this and the ensuing thread…

            Joel Hassman, MD

            Report comment

          • Sure, when a woman tells a psychiatrist that she was sexually abused by her stepfather and he responds by leering at her and asking her if she loved her stepfather, then just kept leering while she knocked over the chair and backed out of his office, then the real offense is her having cartoon fantasies of pistol whipping Freud; because structural violence works for professional misogynists and Freud gave the worst of them a way to blame their victims.

            Report comment

          • Juvenile and emotionally overwrought, my thoughts exactly. My goodness, for an MD and psychiatrist the maturity level sure seems low. That’s disturbing.

            If this individual engages in therapy, that’s scarier, still.

            Physician, heal thyself..

            Report comment

        • Seemed to me that Dr Healy was suggesting that a light be shone in an area where abuse could flourish. That I would like to see done.

          And you suggest shining it elsewhere, because there’s nothing to see here. Well, maybe a little but look over there. I disagree, and from personal experience know that abuses are occuring, and am simply not prepared to turn a blind eye the way many others do.

          Glad you mentioned the Marquis de Sade.

          http://sauravjha1985.blogspot.com.au/2010/04/marquid-de-sade.html

          If my hope that these abusers that I know of will one day be held to account, and punished severly offends you, then consider my fanaticism the product of the persecutions I have suffered at the hands of my abuser.

          You have misrepresented what Dr Healy has said, as much as I have “twisted” you words. Fire with fire.

          Report comment

          • Oh, I want abusers not only punished, but ostracized and removed from public risk as far as appropriately and legally as possible! But, if you claim abuse is “that hurt me” , but doesn’t meet a standard that the general population around the alleged abused individual would inherently support, then, is it abuse, or a feigned injury that, to use an illustration from Healy’s argument above, will be shown to be faked for primary or secondary gain that Somatoform Disorders intend?

            If I say “NO’ and you shriek “ABUSE” as retort, well, words can hurt, but so can neglect. Which is it with some of you, anything a doc does is abuse, and then if he/she chooses to ignore you, then more abuse!?

            Oh yeah, that “damned if you do or don’t adage”. Well, I learned in my training “better to care than to be care-less”. Sort of like that other adage, “better to be judged by 12 than carried by 6”, hmmm???

            Define the boundaries and expectations, but once again, that creates accountability and defined goals. Not an Alinsky agenda at the end of the day, eh? See below at 6:52 for the comment for clarification.

            Joel Hassman, MD

            Report comment

          • Okay, simply saying no is not abuse, I agree.

            I was referred for an examination by a psychiatrist involuntarily. The staff at the hospital wanted me to take two medications to make me sleep, patient management. I did not wish to take the medication as it was known to cause me problems. I am surrounded by 12 staff (security and nurses) and a doctor holds up a large needle containing who knows what. I tell him your not coming near me with that. And he responds by telling me “i’m the boss around here”. Fearing that I would be restrained and injected I took the oral medication and suffered for the next two days.

            Call that consent? I wonder if the same doctor is gaining consent from unwilling sexual partners in the same way. She says no, have her surrounded by thugs and produce a knife. That ought to make things easy.

            Fit your definition of abuse?

            Oh, and the referral? Nothing wrong with me.

            Our Chief Psychiatrist is quite happy with this type of patient management, even calls it “accepted practice”.

            Report comment

          • “Call that consent?”
            It’s the same with “voluntary stay”. I was offered a once in a lifetime offer: “are you staying willingly or do we have to put you in the documents as involuntary?”
            This whole system is absurd.

            Report comment

    • Well, so let’s just ignore the fact that it is notoriously difficult and bordering on impossible to prosecute medical errors and misconduct. Let’s ignore that doctors don’t want to testify against their own kin even if they privately admit that malpractice has occurred. Let’s ignore that iatrogenic harm is one of the leading causes of death.
      And better yet leave the psychiatrists, who are not even worthy to be called doctors, the power to “treat” people against their will and then wonder why “mentally ill” die 25 yrs younger than the general population. Indeed, there is no problem.

      Report comment

      • You know B this statement you made put it together for me.

        “Let’s ignore that doctors don’t want to testify against their own kin even if they privately admit that malpractice has occurred.”

        Have a look at Dr Healy’s last sentence that Therapy First takes issue with in his first post. The potential for abuse by doctors. Then he asks when he will renounce his medical degree.

        I ask, has Dr Healy broken ranks by even mentioning that their is potential for abuse in the relationship? Is the call for his degree a ‘dog whistle’ threat? And then the diversionary tactics of pointing to the Catholic church and police?

        Maybe it’s just me, but I’d certainly like to see a thorough examination of what is occurring in these unequal relationships. I’ve witnessed some of the abuse that is occurring, and applaud Dr Healy for pointing out how easy it would be for a doctor to abuse their position of trust.

        Of course if you can deny there is a problem, then no need to look. And if you don’t look, you won’t see. And what you don’t see can’t hurt you right?

        I have looked, and seen, and yes there is a problem.

        Report comment

        • But I take it as a damning generalization, maybe I am wrong in my interpretation, but, I am not interested in this group’s narrative to define my needs and wants. He writes this to be used to fuel the partisan agenda of antipsychiatry, again, my interpretation.

          Who here that is one of the loudest proponents of psychiatry should be muzzled will tell me I am wrong.

          Careful here…

          Joel Hassman, MD

          Report comment

          • Who here who has no faith or hope that psychiatry will do nothing of benefit for the public thinks I am misinterpreting that David Healy is saying that basically “the easiest place on earth to be an abuser is in the doctor’s office and thus most, if not all doctors, are abusers until proven otherwise”.

            If you disagree, then there is hope the profession has some benefit. If you agree, then you are damning almost every doctor/psychiatrist. Again, careful here…

            Coherent enough now?

            Joel H

            Report comment

          • “Coherent enough now?”
            Yeah, that’s better, thank you for clarification.
            However, I just don’t read Dr. Healy’s words the way you do for reasons I’ve described – namely I don’t think the sentence you cite is to be taken literally as much as “this is the worst experience I’ve ever had” said in a narration necessarily means that:
            http://en.wikipedia.org/wiki/Rhetorical_device
            http://en.wikipedia.org/wiki/Glossary_of_rhetorical_terms
            You see, this is an opinion article and is written in a style appropriate for this literary form…

            Report comment

          • I do believe you are misinterpreting Dr Healys statement.

            “The easiest place on earth to be an abuser is the doctors office” Correct. The trust being placed in doctors is being abused, by SOME.

            “thus most, if not all doctors are abusers until proven otherwise” Incorrect. Show me where Dr Healy has said this.

            I could do the same with your screen name, Therapy first, then …. sure you get my meaning.

            Report comment

    • Joel,

      I appreciate you coming here and talking with us. When David Healy speaks of doctor’s abuse, it is not a simple straightforward abuse where a doctor knowingly hurts a patient. It is abuse that comes from not providing adequate information, not warning the patient of the health dangers of psychiatric drugs, not explaining fully how challenging withdrawal can be.

      Abuse happens in quiet and banal ways when doctors see someone for a few minutes and then prescribe them a drug, or set of drugs that can be addictive, damaging and for some…debilitating.

      This “quiet” abuse is rampant. When 20 percent of Americans are taking psychiatric drugs, something has gone deeply wrong and I hope you would acknowledge that. I don’t personally believe there are many doctors that are knowingly and overtly “abusing” people. But I do believe that by their negligence, by their willingness to ignore iatrogenic illness, by their use of personal power to influence people and prescribe potent pharmaceuticals, they are indeed causing grave harm to many many people.

      I don’t know you. I don’t know how you practice. But I do know that doctors need to take a long soul searching look at their prescribing patterns, and to look at the damage that they are causing. I hope that you stand at the vanguard of those doctors pushing for sweeping change.

      Report comment

        • Anon, we have somebody here at MiA (not on this thread, but on this site) who went to Dr. Hassman’s blog which is called “Can’t medicate life” and has a header which reads “If you want to get better, take a pill, but if you want to get it right, face the truth” and publicly summed up his position jeeringly as “If you want to get better, take a pill.”

          I called her on this virtual libel and she retorted that the missing critical phrase “but if you want to get it right, face the truth” was merely a “non sequitur.” Not only did the commenter not apologize to Dr. Hassman but I was criticized by another commenter for bringing this dishonesty to light. Okay, folks, this is why we’re not taking seriously.

          Unfortunately, this kind of crap is what passes for debate in some sectors of the psych rights movement and the hell of it is that it harms us, all of us. The other side could (and perhaps does) quote many of the comments here at MiA and reasonably conclude that some of us are both illiterate and irrational and not to be taken seriously.

          None of us holds the monopoly on pain and suffering. It is appalling that some of us are so ready to lash out that we don’t even take the time to consider the target. If you take the time to actually read and think about what he says, you’ll see that Dr. Hassman is actually an ally or would have been before he was subjected to this.

          Report comment

          • Well, I’ll disagree with you on that. “If you want to get better, take a pill, but if you want to get it right, face the truth” – sure it offers some context but the first part of the sentence already suggests that simply taking a pill makes you better. Which we all know is not really supported by the data, as in case of “antidepressants” (the quotes are added on purpose).
            I don’t want to comment on Dr Hassman’s opinions which are expressed outside of MIA because I have not read his blog. I merely comment on whatever he’s written under the specific article and his comments here were pretty inflammatory and I don’t really find them constructive.
            Dr Healy points out certain problems with the doctor-patient relationship and the system of wide-spread coverup which follows and the only answer Dr Hassman offers is pointing fingers away from that problem in a “but politicians are worse” manner. And then follows i by:
            “Again, thanks for the validation this blog is as antipsychiatry and antiphysician I have read since the garbage over at Thehealthcareblog.com.”
            That sounds hardly inviting for a constructive dialogue. If Mr. Hassman think everyone here produces antiphysician garbage, why does he even bother to come back? Well:
            “I am going to keep coming back to this thread and take each and every one of you on until you either have a honest and respectful dialogue, or, the authors here will allow the shout downs be so persistent and ugly that it will define once and for all my accusations what this blog is about.”
            I’m sorry but this sounds like a typical strategy of a recently evolved species of an internet troll.

            Report comment

      • Umm, can we stick to the issue at hand I raised in my first comment today?

        Again, for the sake of being respectful for the moment, DR Healy wrote this:

        “The place on this earth where there is the greatest mismatch in power between two people is when doctors meet patients. The easiest place on this earth for an abuser to flourish is in a doctor’s office. Have a look there.”

        Yeah, well I forgot two other important components to American society that I think bests the doctor-patient mismatch: The Catholic Church, and the police.

        Let’s see who can honestly and respectfully debate those two elements aren’t even more dangerous to be abusive than doctors.

        Healy wrote something that is plainly ignorant, if not reckless and insulting on a general scale for physicians. I do not expect the usual suspects at these threads to understand the tone of Dr Healy’s comment, but, I do expect other physicians who read here to think about it, a bit.

        I think after over 20 years of practicing psychiatry the way I was trained and gravitated to providing to all types of people, I have been doing it right and responsible. But, the narrative of this blog must be maintained, and there are no innocent psychiatrists, much less responsible ones with the pervasive tone of posts being presented since I first came here over a month ago.

        I have no issue with you, Mr/Dr Keyes, but, let’s define abuse and make sure it is applicable to what doctors are allegedly doing with any legitimate charge of malfeasance before just uttering it as a generalization?

        Unfortunately to me, there is a Hamas-type element to dialogue here too often, and it needs pondered by the blog authors, in my opinion.

        Thank you for your direct and respectful reply, Jonathan.

        Joel Hassman, MD

        Report comment

          • Again, projecting your interests onto me, sorry I am not interested in the baggage, ma’am. We, which seems to not include you, is to dialogue with others here in an honest and respectful manner if Dr Healy has the right to demean physicians with the generalized comment he ended the post as repeated twice now by me.

            And your effort to take control over a thread neither one of us has any control over at the end of the day speaks volumes for your interpretation. Should the firearm have a wood or ceramic handle?

            Joel Hassman, MD

            Report comment

          • My baggage? Yes he’s a proponent of therapy first, but I you haven’t figured out that he will assume himself to be the expert on any patient’s life and that he doesn’t respect people he considers to be lessors (like patients who dare to criticize psychiatry in any other terms but his) then you don’t get him.

            Report comment

        • @ Joel July 14, 6:58

          You suggest that there are places where greater abuse is taking…sure…I agree with you…I’m sure there is.

          But the scale with which psychiatric drug prescribing is happening is simply immense. let’s take that 20 percent figure. Out of 300 million Americans that would mean 60 million Americans are taking psych drugs prescribed by doctors. Do you really believe that 1/5th of Americans need to be on drugs?

          And if not, then some form of wide scale enormous abuse of practice is happening.

          You may deny it in your practice…fair enough. You may deny it in the practice of others you know. But somehow, an immense over drugging of modern society is happening because…doctors are widely and unnecessarily prescribing these drugs, often causing grave harm to many individuals.

          Would you agree that wide scale abuse is happening?

          Report comment

          • Hey hold on.. I’m not familiar with his blog. Not trying to pile on. Really genuinely interested in his thoughts. I get that he personally is against overmedicating patients. And I also said that he may himself be a careful provider.

            But somehow we have got to a place where 20 percent of Americans are being psychiatrically medicated. Significant portions of foster kids and kids in general are being medicated. this…to me…seems inherently abusive.

            So I am looking to Joel’s thoughts on this. How can that change? How does he think that can be changed in his profession? How did this happen?

            I would frankly prefer if there were more folks like Joel here so we can have a broader conversation…even if we completely disagree.

            Report comment

          • Jonathan, I would prefer more points of view on this blog, too. However, it seems that whenever somebody comes along who doesn’t partake in the groupthink, they are savagely disparaged. That’s not an environment that fosters healthy dialogue. It’s fine to disagree, of course, but if we want to change the status quo, we have to engage with the “other side.”

            By “pile on,” I was referring to the general tone of the thread not any particular post of yours. Sorry for the misunderstanding.

            I feel it’s just being assumed here that as Dr. Hassman is a psychiatrist that he must promote overmedication and I think if people are going to make that kind of leap, they should at least make a cursory enquiry before publically misstating his position. Believe it or not, there actually are good psychiatrists.

            I do find some of the discussions here at MiA incredibly frustrating. I support widespread psychiatric reform but I’m often discouraged by some of the things written here and I wonder what on Earth a random member of the public (who may not have yet formed an opinion on these matters) is going to think when they read some of these discussions.

            Report comment

          • Oh, he’s quick to criticize psychiatry and psychiatrists, but when someone who has been hurt by it/them speaks up, then he suddenly needs to defend it/them against the unwashed masses.

            And, ZOMG!!! drug seekers show up at his office— wherever did anyone get the idea that psychiatrists have anything to do with drugs? It just boggles!

            Report comment

          • I’d ask a different questions:
            If you know that a fellow psychiatrist has put a veteran or a kid on several medications which are known to have mental and physical side effects and interactions and harm has occurred, would you testify in court and call this malpractice?
            Unless the “good doctors” who are supposedly concerned with the overprescribing are not willing to take a stand they basically help covering up medical abuse.

            Report comment

    • “For every legitimate “abuser” you can document in a doctor’s office, I will be able to show you dozens masquerading as politicians, as business leaders, and “pillars” of the community at their home owner meetings/country clubs/PTA meetings.”

      Can I take you up on your offer to Dr Healy? I’ve got two documented aggravated assaults by two separate doctors. Of course once I realised that they were prepared to assault me when they could not obtain consent from me, I became a little more cooperative.

      Report comment

    • “No, Mr. Healy, the easiest place for an abuser to flourish, in order, is one’s home, one’s extended family, one’s business, and overtly of late throughout the globe, one’s political office.”

      Joel, I disagree with you, and agree with Dr. Healy. Please see the synopsis of my situation above. I’d like to remind you that the doctors have an extremely well organized “Wall of Silence” system worked out, and I have medical proof the HIPPA laws are being broken and used against patients. And as you may notice from my case, those supposed to be policing the medical community, are NOT doing it (oh, and I should add to my tale that the patient advocate and lawyer for the hospital I was shipped to Kuchipudi stated his crimes against patients are “proper medical care,” and the Joint Commission didn’t look into that hospital either.)

      Basically, I dealt with many years of well orchestrated, HIPPA informed doctors colluding to cover up a “bad fix” on a broken bone and the medical evidence of the sodomy of my four year old child by way of forcing me onto a bad drug cocktail, then misdiagnosing the ADRs and withdrawal symptoms with psychiatric stigmatizations, then many forced, egregious major drug interaction laden, and poisonous, drug cocktails. I’ve since learned that covering up easily recognized iatrogenesis, with complex iatrogenesis, then controversial iatrogenesis has long been the “dirty little secret” way of preventing legitimate malpractice suits.

      Most families and industries do not have such a well organized system to unjustly protect their own, while harming their clients, and trying to get away with murder – just to cover up a “bad fix” on a broken bone and child abuse. And most haven’t bought out the government to aid and abet in covering up their crimes either. Although, I do know the religions are equally guilty.

      There are reasons the doctors have killed more Americans than have died in all wars combined. The medical community is attracting, at least in my case, seemingly lots of psychopaths. Power corrupts, and absolute power corrupts absolutely. The medical community has too much unchecked power right now, and they can’t handle it.

      Report comment

      • I don’t know about sociopaths (although some claim that there is an enrichment of such unsavory personalities among surgeons and psychiatrists) but it doesn’t take a special kind of person to sign up to be an abuser is such a system. It reminds me of an old joke:

        2 chemistry students are talking and one says to the other: “Man, when I think about what kind of a chemist I am going to be when I finish university I’m really scared to go to a doctor…”

        Unfortunately doctors are people and many of them are incompetent, lazy, negligent, etc. and also some of them make honest mistakes, especially when they’re tired or have a bad day. And the culture of coverup stems from the fact that most of them solidarise with the other doctor. “What if I made the same error when I was tired.” etc. Some have maybe already bodies in their closets. However, this mentality leads to not only honest mistakes being covered up but also cases that are totally inexcusable and criminal. I have friends and family in both the healthcare system and working as lawyers and I’ve heard tons of stories about malpractice and how difficult it is to prosecute. Not mentioning cases of family and friends who were harmed by malpractice, negligence and reckless prescribing.
        Iatrogenic illness is a serious problem and it has to be addressed, not swept under the carpet.

        Report comment

    • I would like some clarification on your statement: “For every legitimate “abuser” you can document in a doctor’s office, I will be able to show you dozens masquerading as politicians, as business leaders, and “pillars” of the community at their home owner meetings/country clubs/PTA meetings.” To resummarize, for any one “presumably guilty” abuser who is a doctor, there are dozens in the community…. Why would you assume that doctors have any less percentage of abuse that any other area such as politicians, business leaders, “pillars” of the community? That in itself is a biased statement impuning innocence a person just because an individual became a doctor. The key is that abusers seek sources of power in order to be abusive while limiting repercussions. But I do not see why the entire article has to be trashed over one statement that was made that may be an oversimplification.

      From what I gathered from the article, the intent of the author was to warn the public to be aware of the potential of abuse specifically in regards to the influence of the Munchausen diagnosis, thus the title. I don’t feel that the one oversimplification has negated the entire article.

      There is a systemic problem in the medical/psychiatric establishment. Many medical personnel have been greatly influenced by the popularity/misknowledge of Munchausen/ Munchausen by proxy diagnosis and all the wrong beliefs that are conveyed with it: that a great number of people are able to cause severe bodily symptoms to themselves due to improper thinking or somehow cause them in another individual. These conditions are extremely rare, but the actions by the med/psych establishment any many countries are spreading the wrong belief system that this is actually a common occurrence. This has catastrophic effects to the healthcare of patients. I have known many individuals who were misdiagnosed of varying physical diseases that have resulted from a doctor writing off a patient as somehow depressed/ or mentally unstable to have caused the symptoms because they could not identify the cause/were unwilling or unable to spend the time to investigate/order proper tests/etc. Now in that regards, it is not only incompetency of the doctor but the entire system itself that is putting emphasis on psychosomatic, bodily distress disorders on a daily basis. It is a systemic abuse that certain doctors can disregard are fully embrace, but the final decision comes down to the doctor of the patient.

      What is your opinion on this phenomena…? I personally am not anti-doc, anti-psych. But I will not turn a blind eye to a prevalent problem that is embedded in medicine, and deny that it exists. Are you denying this problem exists?

      Report comment

  3. No takers at the end of the first evening about my suggestion there are other more abusive relationships in this country that should be scrutinized even moreso than the above allegation of abuse by physicians of their patients, “the easiest place on this earth for an abuser to flourish is in a doctor’s office”. Frankly, why does Healy even add the MD after his name, to add to the alleged abuse covertly??

    What about The Church? The Police? Hey, let’s even throw a third one here I did not really think of until just a moment ago, teachers?

    Damn that narrative here! But, as long as I am allowed to comment, I will continue to press my question, is it fair for Dr Healy to make the generalization without even defining in a realistic fashion what meets the definition of abuse by the physician?

    Talk, or write amongst yourselves, I am busy until 7PM tomorrow night but will be here in earnest to any and all interested to read and reply. Perhaps to interests to dialogue, not just have to duck the projectiles headed at me??

    Be safe, be well. And, try this one, be fair!?

    Joel Hassman, MD

    Report comment

    • I don’t think this is a productive line of discussion. I don’t think the point is to compare whether one situation is more or less abusive than another one. I think that what was meant here was that there is a quality that defines the abuse that takes place that is unique to this relationship; one in which one person is, by virtue of their accreditation by the state – a simple statement of fact, here, as doctors are accredited by the state – empowered to make a determination about another – with very little if any oversight, and no effective means of review or redress on the part of the person being labeled – that will define and determine every aspect of their identity and life from that point forward. Whether you think that this is more or less abusive than another situation, or even abusive at all, is what is at issue here. Getting caught up in the “accuracy” of the statement, which is clearly meant as a term of art, not an empirically verifiable data point, is a pointless and distracting exercise.

      Report comment

      • Art in a discussion like this? Words mean things.

        I agree it is a pointless discussion on what is the most abusive relationship in the world. Which is why I was kind of surprised that Dr. Healy was quantifying it as the “greatest”. Perhaps if he had stated it more simply like along the lines of what you wrote about the state (and I add by society as a whole) it wouldn’t have appeared to so rhetorical.

        Report comment

  4. I’ll accept I made the mistake of glossing over what Healy wrote in the middle per his interpretations of abuse, but, having read it again, I offer to readers this perspective I have had patients share with me over the years perceived as abuse:

    Saying “NO” is abuse. Well, “NO” to what seems to have to be included in the discussion. “NO” in denying people access to basic needs and healthy wants that can be effectively denied certainly could be abuse, but, “NO’ to requests seen as unrealistic or unhealthy, or just plain disruptive or destructive agendas or intents isn’t abuse, it is a boundary. And I strongly feel the answer “NO” should have clarification: if it is absolute, or may change to a “YES” if circumstances change that show healthy and responsible insight and judgment are pursued.

    “NO” I won’t be a part of a plan to harm oneself or others is not abuse. “NO” I won’t write a prescription for a medication that could be abused or misused is certainly not abuse. “NO” I will not ignore you are in pain or distress yet have come to me for some level of help is not abuse.

    Patients do have the right to say “NO”, and if they reveal they have alternatives that show some interest to problem solve or pursue improvements in fashions the doctor either can’t support or can’t understand, but said physician accepts is about seeking health, well, good luck with your “NO”.

    Healy strikes me as a guy who either can’t say “NO” responsibly, or, doesn’t understand that “NO” by itself does not demand respect nor a free pass. I really hope he will respond directly to clarify the abuse definition that fits the narrative of abuse in the doctor’s office, and why he would want to associate with a profession that is instinctively a risk for abuse.

    After all, aren’t we at risk to be judged by who we associate with, eh?

    Hope the above makes sense.

    Joel Hassman, MD

    Report comment

    • Joel again I think you are looking at this on a microscopic level. I am asking you to look at the situation from a systemic level and I’ll ask you again…

      Do you think 20 percent of Americans should be taking psychiatric drugs?

      And if you’re answer is no, then let’s examine how this massive systemic abuse is taking place.

      Report comment

      • Hey, be silent when the equally heinous politicians set the bar for care they have no freakin’ clue where it should be set per honest and responsible standards of care that have shown to be appropriate.

        I think my blog clearly and consistently has noted how I feel about the scum and treachery I would bet over half of you vote for over and over for years that in the end are incompetent, selfish, and disruptive people masquerading as leaders. Irregardless of party affiliation.

        My advice, for what it is worth, pay attention to the forest, not the sole tree in front of you.

        Joel Hassman, MD

        Report comment

        • Politicians where I live are setting the bar for care based solely on what psychiatrist and doctors want.

          They are leaving loopholes that are exploited, and decieving the community into believing they are protected.

          It produces a situation that makes the job easy, and to hell with any standards of care. We will just trust that the loopholes will not be abused by doctors. And this, i believe, is precisely what Dr Healy is pointing to.

          Well, the loopholes are being abused, and those who are abusing are not being held to account. Public image takes precedence.

          Report comment

        • This from therapists blog
          “This is what is MIA’s basic readership. A bunch of clueless, reckless, and rather prejudiced and biased lot of losers. ”
          And referred to shit stained blogs and the lot of commenters as retch.

          Interestingly on his lil wordpress journaling, (his own talk therapy), he refers to clients as cretins.

          We are all a bit disgruntled with certain personality types. And indeed look at the forest, after discovery of the diseased tree.
          So yes, if we can assume that our society has personality disorders and that it has become pervasive in the baby boomers, I would assume that we are all susceptible to these disorders, in one way or another. How we express it, or if we are able to function is not an indicator of how healthy one is.
          And if we express towards certain groups or people, (that includes me) I suppose might be a sign of discontent, but then, I am not ‘treating’ people, who I refer to as “cretins”.
          I never reached that stage within my job, and as a hairstylist, I had the pleasure of serving and listening.

          Report comment

    • Well, I’m not sure if I understand you correctly but assuming that I do I have two comments:
      – of course the doctor has not only the right but also responsibility to say “no” to unreasonable demands by the patient which conflict with his best knowledge
      – the “no” from a patient should be definite – if the patient doesn’t want to accept treatment, even if lifesaving, it’s his/her decision
      The specific problem with mental heath system is that the latter is ignored.
      When it comes to “no” by the doctor things get more complicated because one has to judge if the refusal was actually reasonable and didn’t lead to harm by negligence. Medical errors and malpractice can result not only from a wrong treatment but also from refusal of treatment. In any case the doctor is the stronger party in this dynamics since the only way the patient can change it is by legal action, in which harm has to be proven.
      Therefore in healthcare system the doctor is the stronger party, or authority, with a lot of poorly checked power and in psychiatry specifically this imbalance of power is taken to a new absurd level.
      I seriously don’t have a good idea on how to improve the problem of unbalanced power in the doctor’s office since some of it comes from the fact that it is supposed to be the doctor who has the knowledge and experience so the imbalance is intrinsic to the relationship and in many cases justified. On the other hand it allows for the abuse to happen unchecked, especially with other doctors being reluctant to punish black sheep (which I admit is not unique to physicians).
      When it comes to psychiatry though the power to treat involuntarily should be taken away.

      Report comment

      • Sorry, I do not see these alleged muzzle prints from figurative guns against these patients’ heads many of you claim are in place.

        Patients have said “NO” to me in various elements of care, as an intern, resident, and sole practitioner, and I have begrudgingly said, “fine, your choice, but, hope you weigh all those risks and benefits”.

        And let’s have the most brutal and honest moment of candor about involuntary commitment, which is the real sole topic you as a group may have some legit gripe to bear here. I haven’t practiced inpatient work for much of my career after residency, but, I have NEVER met a patient, without felony or civil charges above the psychiatric matter alone, that has been kept in a psychiatric hospital for many months or years. And that is again one of the disingenuous and dishonest parts of your shrill debate, well, where is the outrage with the judge per those court related matters outside psychiatric competency per psychiatric illness alone?!

        Patients get out of the hospital, maybe at times inappropriately mistreated and very wary to ever cross the mental health system again, but, psych hospitals for mental health care alone are not prisons these past 20 years I have been an observer. Debate the Forensic portion separately, so the apples are apples and the oranges are oranges!

        I very painfully and cautiously, but equally very honestly want to watch the reactions from some of you should you or someone close to you be harmed by an acutely ill psychiatric patient who has no insight and judgment to avoid harming others while in the midst of serious illness. That getting them hospitalized, even for a brief period of time, a few days is the realistic amount more often, might have some impact for pause and reflection to prevent tragedies we seem to read about with too much regularity these past several years.

        Yeah, then the hypocrisy will really flow!

        I am genuinely sorry some of you have been inappropriately treated by providers, and I really believe you have some options that are legitimate and appropriate to try to spare others similar, if not greater pain and anguish. Beating the drum at 100dBs to eradicate a profession is not going to accomplish an effective endpoint at the end of the day.

        But, hate blurs boundaries and realistic expectations, I know, I have been there.

        Joel Hassman, MD

        Report comment

        • “I haven’t practiced inpatient work for much of my career after residency, but, I have NEVER met a patient, without felony or civil charges above the psychiatric matter alone, that has been kept in a psychiatric hospital for many months or years.”

          I personally know of two people I have worked with recently who have done two lengthy stints of over one year each in the hospital. One stretch, in fact, involved multiple years. Neither of the two were put there by the criminal courts. One of those people is still in the hospital.

          I don’t thank this kind of thing would be happening so frequently if some of those providers you mention had been treated in like fashion, but you never know. There is a brand of “consumer” these days that would readily respond to all sorts of job offers, promotions, and varieties of bribery, blatant or subtle, especially as not doing so would mean remaining under-appreciated, marginalized, and unemployed.

          From what I’ve seen patients have much more to fear from doctors and hospital staff than they do from their fellow patients. This is what the high mortality rate tells us. People are dying from conditions associated with metabolic syndrome.

          As for human on human attacks (staff don’t get punished for their sort of attack), we have an alienation/violence problem in this country right now, don’t we? The problem doesn’t stem from any “mental illness” either. What’s that? Nor “lack of insight” per se. The problem is that we are fostering an aggressive, arrogant, success at all costs culture, and that’s what you get from that sort of thing. It isn’t all lovey dovey, anything but, and where you don’t have love, violence may erupt. Sometimes, when matters become superficial, it’s just a matter of the truth getting out, if not thoroughly.

          Report comment

          • Honestly, having witnessed some of the everyday practice in a psych ward I think the “mentally ill” have to be one of the most peaceful populations there are. I think if the abuse from the staff was met with self-defence and understandable resistance there would be dead people every day.
            This system is abusive and authoritarian and has to stop.

            “The problem is that we are fostering an aggressive, arrogant, success at all costs culture, and that’s what you get from that sort of thing.”
            Good point.

            Report comment

          • “As for human on human attacks…we have an alienation/violence problem in this country right now, don’t we?…The problem is that we are fostering an aggressive, arrogant, success at all costs culture, and that’s what you get from that sort of thing. It isn’t all lovey dovey, anything but, and where you don’t have love, violence may erupt. Sometimes, when matters become superficial, it’s just a matter of the truth getting out, if not thoroughly.”

            What we’ve alienated ourselves from is our naturally loving selves, which is why groups alienate and marginalize certain members, as they are threatening reflections of what they don’t want to see or feel in themselves. If a person makes you feel bad, then it is your bad feeling to deal with and heal, not theirs. That’s just simple self-responsibility, a tough one for many, I realize. We are a scapegoating and blaming society, on a whole.

            It is part of life that we affect each other not always positively; our agendas don’t always coincide, even among people who feel a connection with each other, on some level. If someone makes you feel bad often, then get away from that person and don’t look back! That is self-loving self-care. One can still have compassion for a jerk, just don’t hang out with them.

            While we can all act like jerks at times, some people seem to be perpetually mean-spirited and chronically invalidating and demeaning. They are jerks because they, too, have lacked love in their lives. To me, there can be no other reason for hurting others and getting angry, defensive, argumentative, or demeaning when it is pointed out.

            I believe if the anger were to clear, what we’d really feel is sad, before we allow ourselves to fully embrace unconditional love. Our society is one of walking wounded. Just about everyone I know has suffered trauma and abuse, it’s certainly not confined to the mental health world, not in the slightest. But I certainly wouldn’t turn to the mental health field in any way shape or form in order to find clarity and healing, should I ever need support in the future. To me, I got the opposite of healing and clarity—more confusion and more feeling disoriented, fragmented, and ill. Only by turning my focus to other paradigms of healing–those that can be met with tremendous stigma in the more academic circles of our society–was I able to reverse this, and be on my way, healthy, whole, grounded, free, and personally sovereign.

            And yes, this level of self and social alienation that we are currently experiencing does tend to create chronic rage and fear, causing violent chronic thoughts and actions toward one’s self, others, or both. That’s a terribly painful existence, that needn’t be. And if any love does manage to get through, during possible moments of clarity and feeling connected to the collective consciousness, it is merely conditional—based on the condition that “you fulfill my needs without question. If not, there will be consequences to fear.”

            Abuse of power has become a way of life in our society. When we heal the belief that we are perpetual victims and stop identifying with it, and empower ourselves with kind, compassionate, and self-validating beliefs, then the abusers lose their power, and have only themselves to turn against. At the same time, we’ve done our own personal health and well-being a great service, and can feel a lot of relief from this shift in perspective.

            No, it is not lovey dovey, that would be unrealistic, and also kind of boring and irritating, as nothing is created from such placidness. There is no challenge with this.

            Unconditional love can be tough love, and experienced in the face of chaos and mean-spiritedness. It ain’t easy, but it does resolve issues and moves things forward, rather than keeping them stuck in an emotional quagmire that seems inherent in how we relate to our society, in general.

            As always, we have choices in how to perceive our experiences. I suggest striving for unity and wholeness, rather than fragmenting anything off, simply because of our fears and suspicions. Fear-based mentality and living is what got us all into this mess to begin with. I don’t see how that is going to resolve anything. In fact, it only repeats the dynamics about which we are complaining.

            Report comment

        • And this

          “Sorry I do not see these alleged muzzle prints from figurative guns against these patients’ heads many of you claim are in place”

          Thats easily resolved. Your whole point has been to not look, or to suggest looking elsewhere.

          As far as the dangerous mentally ill patients who are doing harm to others, take a look at the movie “Ghosts of the Civil Dead” if you have the stoach for it. Sometimes the system can profit from creating monsters and releasing them back into the community. Shock doctrine. Its being done in my country as I write.

          Having trouble passing draconian laws? Let a few dangerous mentally ill people fall through the cracks. We’ll get support for this Bill.

          Report comment

          • Actually that’s happened recently in Poland. After the fall of communism there was a broad amnesty for prisoners which basically abolished all the death sentences. Instead all the people who were sentenced to death were instead sentenced to 25yrs in prison due to some legal loophole that prevented them from getting a life sentence. Among those were plenty of criminals who had nothing to do with politics and were in prison for serial rapes and murders. One of these guys, who raped and killed several young boys, has recently finished the sentence and was about to be let out. Of course panic ensued – press was fear mongering that he’s going to get out there and kill and rape and so on. Sure, guys like that are usually not reformable and that was the problem but that’s one guy in a whole country and afterall he did his sentence and if you like it or not should be free to go. Instead the government pushed through a law which basically allows you to indefinitely lock up any person who finished a prison sentence for a serious crime if they’re deemed “criminally insane” and danger to society.
            What I was actually surprised about was that there was a wide spread public outcry against this law, suggesting that people are not buying such tactics. Maybe centuries of oppression actually teach people something… Unfortunately the law passed nonetheless.

            Report comment

        • “patient, without felony or civil charges above the psychiatric matter alone, that has been kept in a psychiatric hospital for many months or years”
          A colleague of mine – 3 months.
          Sister of my ex – several months.
          This guy in Germany: http://en.wikipedia.org/wiki/Gustl_Mollath – 8yrs

          Btw, keeping someone for a day or a week and forcing them to take meds and restraining them is just as criminal and is considered torture by the UN. Keeping people for moths/yrs just makes it exponentially worse.

          “where is the outrage with the judge per those court related matters outside psychiatric competency per psychiatric illness alone?!”
          Well, if you take some time and browse through other articles at MIA and many posts there is plenty of outrage about the complicity of the legal system.

          “I very painfully and cautiously, but equally very honestly want to watch the reactions from some of you should you or someone close to you be harmed by an acutely ill psychiatric patient who has no insight and judgment to avoid harming others while in the midst of serious illness. ”
          I’d similarly like to see your reaction have you been mistreated and tortured the way many people here were and had to suffer possibly life-long consequences, both mental and physical.

          “But, hate blurs boundaries and realistic expectations, I know, I have been there.”
          Personally I’d appreciate if you didn’t accompany every comment with a poorly concealed insult if you’re here indeed to facilitate “respectful and rational discussion”. That is, as I’ve mentioned before a provocative tactics of a troll.

          Report comment

        • My child has been hospitalized against her will for several years. Long stints in the hospital cause hopelessness and despair, and Therapy First, hospitals are the same as prisons, in some ways they are worse. In hospitals, you never know when the release date is. In prisons, you always know when your release date is. The discharge always depends on a placement

          Report comment

  5. What we call corruption is flourishing for sure. Not a profession or business that has not been given an opportunity to host this condition, and all the important ones have signed on. No place for the innocent to run to and hide. You have penned an excellent article that I will be sending on to several.

    The corruption of the best things gives rise to the worst.
    David Hume

    Report comment

  6. “My baggage? Yes he’s a proponent of therapy first, but I you haven’t figured out that he will assume himself to be the expert on any patient’s life and that he doesn’t respect people he considers to be lessors (like patients who dare to criticize psychiatry in any other terms but his) then you don’t get him.”

    Well said Wileywitch although in all fairness, many physicians are like Dr. Hassman. On a related note, when I thought I was going to have surgery earlier this year and due to my concerns about my sleep apnea and med sensitivity, I asked the head anesthesiologist to give me a list of meds that would be used during the surgery so I could check them for side effects pertaining to my situation. I finally obtained the information but I swear, getting it was harder than infiltrating Al Queda.

    This guy kept stating that I needed to trust that they knew what they were doing which greatly bothered me, particularly since patients with sleep apnea are at much greater risk for post surgical complications. I had every right to ask the questions that I did.

    By the way, Dr. Hassman or anyone else reading this post, this is not an antipsychiatry or anti physician post. I am simply commenting on what I have experienced with the understanding that there are good physicians out there who do treat knowledgeable patients with respect and take their concerns seriously. I have two doctors on my team who are like that and hopefully, when looking for another needed specialist, I will find that person who meets this criteria.

    Report comment

    • You’re right. There is a certain attitude in large areas of the medical field. In my case, most doctors were ok; I had more trouble with staff. One OR tech glared at me with hate because I wasn’t getting conscious sedation. Must have thought I was a drug addict or he just didn’t want me to remember him; I don’t know.

      Take care of yourself. You’re the only one with a vested interest in your health. And, if possible, always take someone with you to the hospital. I worked in them for 13 years, and it was my advice to everyone I knew undergoing any type of procedure.

      Report comment

      • Wow anon, you committed a crime because you didn’t want conscious sedation? At least the anesthesiologist didn’t give me a hard time when I said I didn’t want versed for a preop medication.

        Report comment

        • Heaven’s no, not a crime. Is that more of this rhetoric thing I keep hearing about?

          Just kidding.

          It wasn’t the anesthesiologist; just one of his peeps – an OR Tech. After I was a “criminal” in the OR, I ended up being a curiosity in post-op. They just had to know what paradoxical reaction I had after taking Versed because they had never heard of that before.

          A few months later when I underwent a colonoscopy without sedation, I moved to being a mild amusement. But, when I hit two endoscopies without it, then I became A HERO.

          See, it is all about perspective. That is why I am not often offended by insults on the internet. I have too much adventure in my real life to be concerned with strangers.

          And, it is also all about who you get as your doctor (and other providers). So, I hope you find a good one soon.

          Report comment

    • You are two faced AA, perhaps writing this will get the comment stricken, but, I am on to you now, and you don’t know me but make comments like you are over my shoulder every day of my life!

      Dishonest and disingenuous, you can infer and interpret as you want from what i WRITE, but, you write like your opinion is gospel. And, it ain’t!

      Good luck in your pursuits.

      Joel Hassman, MD

      Report comment

      • Dr. Hassman,

        I hope your comment doesn’t get deleted because you just proved my point that people don’t react negatively because you’re a psychiatrist but because of what you say.

        And by the way, Jonathan Keyes asked some great questions of you which you haven’t responded to.

        Anyway, I am going to find that great doctor I am looking for and that definitely is gospel. 🙂

        Report comment

      • Please, stop trolling. “I am on to you now, and you don’t know me but make comments like you are over my shoulder every day of my life!”
        I’m reporting the comment because it’s unnecessarily inflammatory and makes no point other than offending the people here.

        Report comment

        • Thanks B, I understand your anger and if you reported the comment, that is fine. Personally, I hope it doesn’t get deleted for the reason I stated above but obviously, it is the call of the blog moderators as to what they want to do.

          Report comment

          • Hey, and thus the blog has moderation and control outside your own opinions and agenda. that has to hurt a bit for some here. The rigid and inflexible really can’t handle honest and fair boundaries if it doesn’t benefit the narrative.

            I know, I have seen other sites that keep you folks out overall.

            Joel Hassman, MD

            Oh, and trolls almost always don’t use their names, don’t offer facts and truth, and never say sorry. Oops…

            Report comment

          • Well, I’m not saying you’re a troll but you certainly behave like one in some of your posts. It’s ok to disagree but when you constantly preemptively attack people here and proclaim that you’re only visiting this site to provoke us into showing how vile and stupid anti-psychiatry proponents are – well that’s what a good troll would do, name or no name.
            “Oh, and trolls almost always don’t use their names, don’t offer facts and truth, and never say sorry. Oops…”
            That is absolutely not true. In fact a good troll will do all of these things – it makes the act more believable.

            Report comment

  7. Francesca,

    I couldn’t disagree with you more regarding Dr. Hassman. I won’t speak for anyone else but I react extremely negative towards him because of his responses on this blog that in my opinion don’t come across as seeking dialogue. I have made absolutely no assumptions about how he practices psychiatry.

    I actually believed him when I felt he said something to the effect that he was different off the computer vs. being online. I may not be remembering that accurately so hopefully Dr. Hassman will forgive me if I did and set the record straight.

    AA

    Report comment

    • I’ve been reading blog comments for close to seven years. In that time I have only read apologies from a handful of people. Dr. Hassman happens to be one of them.

      You never know who is going to end up being reasonable once you get over the strife.

      Report comment

  8. “Information is power.” Historically, there were two original educated professions, meaning two more powerful professions, the doctors and the clergy. It has been confessed to me that also historically, there has been a “dirty little secret of the two original educated professions.” In essence, the “secret” is that doctors have historically covered up their “easily recognized iatrogenesis” with the help of psychiatric stigmatization and tranquilization. And that pastors have historically covered up their child abuse with psychiatric defamation and drug poisonings. We now all live in the information age, where all are able to research medicine for free, so now any patient can medically prove misdiagnosis and poisonings. Perhaps it’s time for this “dirty little secret” abuse of power technique of the “two original educated professions” to end, please ? I’d like to see the child molestations end too, please.

    “‘The psychopharmacology establishment in the face of adverse effects from drugs’ is the same as ‘the medical establishment in the face of treatment-related adverse effects’ is the same as ‘the British establishment in the face of allegations of paedophilia and child abuse’ is the same as ‘the Vatican in the face of allegations of abuse.’

    It’s about power. We have it – you don’t. Get lost.”

    Unfortunately, this pretty much describes the medical and religious crimes my family has dealt with over the past 15 years. I am dealing with an on-going cover up of the sexual and spiritual abuse of my children by my ex-religion, not to mention the attempts at my life via the “dirty little secret,” based upon a written list of lies from my ex-pastor. And I am being told by my former doctors that covering up medical evidence of child sodomy and a “bad fix” on a broken bone, with a bad drug cocktail, then a bunch of defamation with “lacking in validity” disorders and major drug interaction anticholinergic intoxication poisoning, then even attempted murders by a doctor whose now been arrested by the FBI for extreme betrayal of trust of many patients resulting in many patient deaths, is “appropriate medical care.”

    Thank you, Dr. Healy, for pointing out these egregious abuses of power. Forgive me for being disgusted by a paternalistic and greedy society that has empowered a faction of the medical community with the ability to unjustly and hypocritically defame, discredit, and harm patients to cover up the mistakes of the incompetent doctors and the pedophilia of the religious and governmental leaders.

    Report comment

    • Which reminds me— in order to explain how a seven year-old girl contracted a venereal disease, some brilliant physician deduced that VDs could be transmitted from toilet seats. I mean, how else? Really? Really. Such concern and professionalism.

      Report comment

  9. Once within the medical field there were a few doctors who seriously regarded the truths real science revealed. M.D.s became practicing Traditional Naturopaths or Homeopaths and had the plain courage to throw overboard false paradigms and align their practice with what really worked for the benefit of the suffering person that came to them for help. Doctors like Lindlar, Benjamin Lust, Tilden,Shelton and many other honest M.D.and non M.D.’s in healing professions some authentic ones practicing today are at the Paracelsus Klinic (yes K) in Switzerland headed by doctor Rau M.D., Richard Schultz N.D. at http://www.herbdoc.com also Linda Page N.D. also a Traditional Naturapath (one of her books ” Healthy Healing”) of course the indomitable Charlotte Gerson of the Gerson Clinic teaching what her brilliant father Max Gerson M.D. taught and practiced. There are 3 vitally important videos of her teaching on youtube. Of course there are more authentic healers.
    Today with the giant gorilla (PROFITORY PSEUDO-SCIENCE) in the room of every industry and government and most every enterprise ,we are in deep s–t.
    Where are the psychiatrists that will arm in arm with psych- survivors throw this insidious psychiatric enterprise overboard with enough gusto too shake it to its core ,drive it to the dustbin and let something beautifully honest bloom devoid of pseudo science, coercion, and oppression. Of course not leaving behind those still caught in the net of the deadly paradigm.

    Report comment

  10. i am going to end my participation at this thread for the next couple of days with this effort to give you an image who Joel Hassman, the citizen first, is about at the end of the day:

    Know the movie “Field of Dreams” well, the scene where Costner and wife are in the Gym fighting the school board trying to get books banned? Well, I greatly identify with the wife who stands up watching all the weak and disempowered just go along with their failed leadership, saying fairly much “who wants to be ruled by Stalin, by Hitler, who wants to just roll over and have it given to you long and hard!?” Yeah, I am the guy who will have the guts to say, “Man, this is wrong, and you all sit here and say nothing, you deserve to be not only screwed, but then say thank you for the assault at the end!”

    When you think someone is wrong, you speak out, and you listen to the rebuttal, and if it is wanting dialogue and negotiation, then you will be not only be thanked by your choir, but by at least some from the opposition too.

    But, I think the pervasiveness of personality disorder in multiple facets of our culture is not only entrenched, but effective. And they want you, the public, to just shut up and do nothing. Again, stick to the facts, the truth, and how it impacts the public at large, and then watch the enemy either slink away, or be ready for them to be in your face.

    At least the latter shows the real agenda at that point!

    Be safe, be well, be fair, and be honest. The Quadfecta for the week until Thursday.

    Joel Hassman, MD

    Report comment

  11. STAT, Nurse Rachet, “Prepare an injection of 200,000 mg of halidol! “He exhibits signs of forthcoming aggressive tendencies, co-exhibiting with extreme delusions of grandeur, with overt homicidal mania ideations. “Get Jaws and Lurch here as quickly as possible to assist with the injection, and strap down protocols. He is attempting to escape! Electrification may be necessary. Keep him away from the toilet, he has threatened to drown himself repeatedly. Call me in a couple of weeks in the event he realizes he is not a psychiatrist. Monitor his every move. If he continues to display patterns of incoherence, increase his dosage 1000mg as needed. Oh, take away his socks so that he’s unable to harm himself or anyone else.”

    Report comment

  12. I can’t find the comment Therapyfirst made about this Alinsky tactics.

    Shame really because it is comedy gold. It could have come from the DSM, one size fits all, except me.

    Stick whatever label you wish on me Therapy First, what I know is that in a fight for my life, i’m not worried about what i’m being called, I will do whatever it takes to survive. In the words of Malcolm X, “by any means necessary”.

    Report comment

      • No, that’s fine Emmeline.

        And maybe I got such a laugh out of it because I’m one of the “usual suspects” and misunderstood the tone.

        “I do not expect the usual suspects at these threads to understand the tone of Dr Healy’s comment, but, I do expect other physicians who read here to think about it, a bit.” Therapy First 14 July 6:58 pm

        I mean it’s fine if the Emperor wants to wander around the Palace naked, but a flasher in a crisis referral centre is seen and treated a little differently. Maybe Therapy First can let us know if we, the “usual suspects”, are free to comment on his posts, or if they are only for the benefit of physicians who understand.

        Anyhow, I’m late for my Voodoo class, and it’s how to understand ‘magic bones’ tonight.

        Report comment

  13. Well, that was all quite the read, and the doc was sure lucky to actually get
    people to respond. Well of course you never know if he was thinking
    that he was somehow ‘making posters respond’.
    As far as debate, one can’t debate with people who call
    clients “cretins”. Their mind is rigid and inflexible and it all
    just becomes projections. And no MI cretin wants to be exposed
    to disgruntled shrinks who run around online with their problems.
    We have a massive amount of medical people who are disgruntled
    and I COMPLETELY understand that, since it is part of our world now,
    YET, you simply cannot take it out on the consumer. Once you reach that point
    you should leave the profession.

    Report comment

LEAVE A REPLY