A ragged man on the street corner in Los Angeles was doing magic tricks for several enraptured children. He placed a coin under a cup, then moved the cups around rapidly and skillfully without saying a word to the kids and then asked one of them to find the coin. The child, of course, couldn’t find it and suddenly, amazingly it appeared out of the man’s ear!
Magicians capture our youthful attention and know the art and the science of making us believe that they are empowered with the gift of making things appear and disappear. My Dad was a magician (also a brilliant physicist) and, at his knee, I learned the art of distraction, sensory manipulation and magic. In my crisis intervention work with overwhelmed and vulnerable people in the psychiatric emergency rooms, the jails, the locked in-patient units I watched as patients and families who are overwhelmed with the pain, the fear, the shame of their situation become an audience for anyone with a magician’s skills.
What does this have to do with psychiatry?
In many MIA posts and outside sources I hear the voices of people who perceive psychiatry as an omnipotent force in society. They are perceived as so intimidating and powerful that they have inspired the “anti-psychiatry movement” (which I subscribe to). It is true that many people who suffer from emotional pain do follow their psychiatrist’s recommendations and trust their diagnostic skills and prescriptions for treatment. It is also true that these skills rely a great deal upon the smoke and mirrors of Magic.
When we change our perception of Psychiatry we change the way that we respond to them and we can shift the balance of power that currently appears to rest in their profession. Psychiatry has historically struggled with status; they have been considered the step-children of the medical profession and, in the words of many people “not real doctors.” They have also, historically, competed with psychologists who want prescribing privileges, nurse clinicians and physician assistants who are skilled and rising in popularity as primary medical providers. The environment is worse now for psychiatrists than ever before as insurance companies use MFT, LCSW and other professionals to do treatment while psychiatrists are considered “script writers.” There is a sense of desperation within their ranks. I know this first hand; a close relative is a psychiatrist, my uncle was a well known psychiatrist and many friends are also in this profession.
Now for the Magic. Making a person believe the unbelievable involves a strategy that most abusers, salespersons, cult leaders and politicians know. The strategy is to take an authoritarian stance, distract the object of your rapt and vulnerable attention, hold the attention of that person and then perform a trick or abuse them or give them the information that you want them to believe in. It is the power and control strategy played out in many scenarios. The underlying elements that make the magic work are Trust and Vulnerability. The magic works perfectly to ensure that the believer is ensnared when the person trusts the magician/abuser/salesperson and the person isvulnerable, overwhelmed, frightened, confused and desperate for solutions.
People in emotional distress are all of the above and so are their friends and families. They are in a position where they feel that they have to trust an “authority” figure and they do so rather quickly.
When people question a magician he states that he cannot reveal “how” he does his tricks; this information is withheld because the knowledge would undermine the belief system. When people question their psychiatrists, some of the misinformation that they receive has been well documented in MIA articles and it is “you have a chemical imbalance” or “you are seriously mentally ill” or “you meet the criteria for this diagnosis.” This has the effect of stopping the questioner in their tracks and engenders a sense of shame and failure to have solved the problem. This works as effectively as the shell trick.
Psychiatry is mostly smoke and mirrors. The practicing psychiatrist, if he or she is not simply writing out prescriptions, is encumbered with the burdens of his or her profession; insecurity, insincerity and the constant pressure to see more patients in less time. A psychiatrist must perform their magic quickly and
- To appear powerful, knowledgeable, and trustworthy
- To emphasize the seriousness of the illness and hold the attention of the fearful patient
- To dispense with questions and isolate the person from others who might do research or ask for information.
- To offer the only possible, believable solution to the pain and suffering-the prescription.
The above is an opinion piece and the writer welcomes all views and responses. I do “believe” that changing our perceptions about psychiatry can be helpful and stimulate conversation about reform and about engaging the non MIA population in the discussion.
