In what ways can psychiatric treatments, and the relationships between psychiatrists and patients, be appropriately characterized as “abusive”? On his blog, MIA Foreign Correspondent David Healy posts an excerpt from his book Psychiatric Drugs Explained that explores some of the similarities between situations of child or domestic abuse and psychiatrist-patient dynamics.
Healy starts from the premise that sometimes forced psychiatric treatment may be necessary, but then describes situations “where a paternalistic approach to patients may involve an insidious loss of autonomy that may be counter-therapeutic and ethically dubious.”
He then delves into the psychological dynamics of the power relationships between psychiatrists and patients in terms of over-prescribing and excessively high doses of drugs, the dependence of patients on the source of their prescriptions, fears of disclosure, lack of public awareness of or political support for victims, and entrapment.
“A common response to this point is that there is a difference between the intent to take advantage of children found in child abuse and the worst that clinicians can be accused of,” writes Healy. “Doctors do not casually or deliberately ‘violate’ their patients. This probably overestimates the degree of conscious intent to harm in many cases of child abuse and sexual harassment and underestimates the harm that can be done by clinicians ‘who know best’.”
Dr Munchausen: Pharmacophile (DavidHealy.org, September 10, 2014)