Psychiatry: Smoke and Mirrors

Margaret Altman, MSW
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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.

18 COMMENTS

  1. “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 ….”

    I completely agree, the insecurity and insincerity of the psychiatric industry is truly a problem. I’m working on writing the story of my experience with the psychiatric industry. I had been railroaded into “the system” by doctors who were paranoid of a malpractice suit do to a “bad fix” on a broken bone. And when I went outside my insurance for a second opinion, I had the misfortune of running into a therapist who, unbeknownst to me at the time, had the goal of covering up the sexual abuse of my child for friends of hers.

    As I’m going through my journals from that time, which discuss my dealings with insecure and insincere unrepentant child murderers / child abusers, it’s amazing how easy it is to compare these insecure and insincere psychopaths with the psychiatric profession as a whole.

    • May I have a piece of your writings for the book I’m compiling with input from the MIA community? Please email me at [email protected]
      I’m especially interested in how you (and others) were railroaded into the system; how you lost your “voice” your sense of what was best for you. One experience would be great.
      Thanks
      Margaret “Voiceless in America”

  2. I have had mental health professionals who would discount everything that came out of my mouth for being what they considered symptomatic of “sickness” (lunatic ravings, new version), not because what I said was irrational, but because what was said was said by a person who had been given a psychiatric diagnosis.

    Psychiatry would meet the magical thinking of the mad with it’s own form of magical thinking. The incantation of the psychiatrist is a psychiatric label, it explains everything by explaining nothing, and allows the cursed/enchanted person to be treated as entirely unworthy of consideration and, more or less, invalidated as far as humanity is concerned.

    All it takes is a couple of words, and what was once seen as a human being has devolved into something less than a human being, and everything associated with it must now be likewise depreciated. Recovery from this depreciation then represents recovery from psychiatry. Technical pseudo-scientific jargon isn’t the only language in the world, and so there is way out of this incantatory dilemma, that is, there is also non-mental health.

    Thank you for this post. I, too, think there is often a great deal of ‘Oz, the great and powerful’, in psychiatry, framing a trickster’s filching skills in scientific sounding terms.

    • “I have had mental health professionals who would discount everything that came out of my mouth for being what they considered symptomatic of “sickness” (lunatic ravings, new version), not because what I said was irrational, but because what was said was said by a person who had been given a psychiatric diagnosis. ”

      Catch 22 – everything is a symptom. One of my symptoms was “high intelligence” because that meant I was narcissistic (and that whole narrative was created by the psychiatrists from one sentence where I disclosed my profession). These people are so ridiculous and yet cloak themselves in the shroud of authority so that almost nobody seems to stop and think: “hey, wait a second…”. Being in the middle of a major life crisis does not help this either – you feel something is really wrong here but putting your finger on it requires a moment of peace and undrugged mind.

      • Nicely said, B, and I had “high intelligence” and “creativity” called symptoms of a major mental illness, too. And I even had a doctor called himself a “Dr. #22,” in my medical records, likely because his wife and he had catch #22’ed me into the system because they were paranoid of a nonexistent, but potentially legitimate, malpractice suit.

        • Someone Else – Outrageously aggressive and malevolent foul play made of his play on words for your “benefit”. Foul play, when it sinks to the level of making fun of your case right in the paperwork for it, creates evidence that points at its author’s swollen head and puny conscience. Let’s all figure out how to say goodbye with you to Dr. 22, somehow. Forever.

          • Sorry that got worded ambiguously–I definitely didn’t see that until now! He made the wordplay into foul play, is something I still can’t think how to say in the style I wanted. But maybe then again it was too much for me to say intelligently with all the contempt hitting me full force. His contempt as it surfaces in this jibe against you actually reminds me of nothing less than what hate speech is meant for. (See Nat Hentoff’s “Free Speech for Me, But Not for Thee”–) My own contempt for Dr. 22’s malignant, hateful action was probably too overwhelmingly happy for me to recognize for me to stay creative.

  3. “The incantation of the psychiatrist is a psychiatric label, it explains everything by explaining nothing, and allows the cursed/enchanted person to be treated as entirely unworthy of consideration and, more or less, invalidated as far as humanity is concerned.”

    I had gone to the same psychiatrist for 15 years being told I was profoundly ill and being heavily poly drugged. When I went to a new psychiatrist he said I was not mentally ill and refused to prescribe any drugs. Once a diagnosis is “out there” we are suddenly very vulnerable, over looked, denied medical help even when psychically ill and disregarded. No one should be treated this way. I’m out spoken to many on the dangers of psychiatry and psychiatric drugs and can only hope someone does listen.

    • Aria – Beautifully stated and such a kind reminder of what can happen if doctors are good at their jobs, even if nothing gets reformed besides some mainstreaming of our route of access to legal recourse (like by critical psychiatrists, maybe?) for pursuing reviews of our diagnoses for anyone who would like to sue the bad doctors…. I can’t think of any blogposts on that, or would link them for you. Sorry.

  4. You are a gifted writer advocating for the disenfranchised; thank you for your community service.

    Psychiatry relies on smoke and mirrors because its premise is wrong; mental distress is not a medical problem. Psychiatrists are considered omnipotent because our culture also believes that mental distress (at least severe mental distress) is a medical problem. Our culture believes that the painful irrationality of mental distress (emotional distress) is a disorder or defect of a normal mental process. This is a logical deduction from a false premise about normal mental processes- about brain functioning.

    Natural Psychology explains the scientific anomalies at the foundation of psychiatry (and our current psychology paradigm) and explains human psychology by solving these scientific failings. Natural Psychology explains mental distress with elemental neuroscience; mental distress is emotional distress- the natural neurophysiology of distressful experiences. Natural Psychology is published online at NaturalPsychology.org; criticism of this scientific thesis is greatly appreciated.

    Best wishes, Steve

  5. This movement is terribly harmful to not only people who suffer from mental illness, but also the stigma surrounding mental illness. I do not doubt that there are bad psychiatrists and there might be many who are eager to prescribe pills, but this happens in other medical fields as well. The medical community is often attacked for prescribing antibiotics when they aren’t needed… so why isn’t there a movement to be anti-medicine? Because the problem isn’t with the validity of the field, but to certain habits that might occur. As a person suffering from Chronic Anxiety with Panic Disorder and Chronic Depression (also ‘double depression’ with complicated bereavement) for over 15 years, i can attest that psychiatry is the only reason I am able to function on a day to day basis and support myself. Also I have just began actual therapy because I am now able to afford it, and long term emotional issues I have are beginning to be worked out and I am so glad. I do not discredit each of the commenters accounts… that someone might abuse or take advantage of your trust is despicable, but there is another way to combat such abuses. One being better access to health care for the majority of Americans, or to demand better oversight of these fields. I am not an expert on psychiatry in general, but knowing what it has done for me and many others I know it is a valuable service for many people. This movement adds to the shame and misunderstanding that the general public has for mental illness. I wish you all luck and happiness with your life and endeavors. Thank you for reading this.

    • “The medical community is often attacked for prescribing antibiotics when they aren’t needed… so why isn’t there a movement to be anti-medicine?”

      Because antibiotics when prescribed properly actually help against the real disease states with known etiology and have relatively few rare side effects? None of which can be said about psychiatric drugs.

      “As a person suffering from Chronic Anxiety with Panic Disorder and Chronic Depression (also ‘double depression’ with complicated bereavement) for over 15 years, i can attest that psychiatry is the only reason I am able to function on a day to day basis and support myself.”
      I don’t know what help you have in mind but if this comes in the form of benzos or SSRIs your depression is very likely a withdrawal reaction. Most depressive states go away by themselves and anti-depressants have no scientifically confirmed efficacy. It’s a travesty that they are still on the market as “anti-depressants”.

      • Kmac said, “The medical community is often attacked for prescribing antibiotics when they aren’t needed… so why isn’t there a movement to be anti-medicine?”

        B said, “Because antibiotics when prescribed properly actually help against the real disease states with known etiology and have relatively few rare side effects? None of which can be said about psychiatric drugs.”

        It is absolutely not true that antibiotics have rare side effects. Google cipro side effects.

        Additionally, I had symptoms of a yeast infection which was very painful and vomiting when I was given one as a prophylactic measure before minor surgery.

        Kmac, you make a good point but the reason there isn’t an anti medicine movement is that antibiotics aren’t forced against your will. Most doctors will not do surgery if you decline an antibiotic when they are typically given before an operation although mine gave me the option to which I didn’t do since I hadn’t researched the issue thoroughly. So I guess one could argue that is a type of coercion but still not the same thing as forcing you to outright take a medicine against your will.

        Finally, I don’t have a link but I read somewhere that only 2 to 10 per cent of all drug side effects are ever reported to the FDA. As a result, I don’t thing anyone, including physicians, truly knows how often drug side effects truly occur.

    • kmac,

      If something’s working for you, absolutely continue with your psychiatric treatment. And all the more power to you. But the truth of the matter is for at least a percentage of the patients, and now it’s looking like a fairly high percentage of the patients, the psych drugs can actually cause the symptoms they claim to cure.

      And I’m not anti-psychiatry, so much as I’m anti-unethical doctors. But I understand the mere existence of unprovable DSM disorders makes so much of the lack of ethics within the mainstream medical community not only possible, but highly profitable.

      And I completely agree, “there is another way to combat such abuses. One being better access to health care for the majority of Americans, or to demand better oversight of these fields.”

      I particularly agree with the “better oversight of these fields” is needed part. The DPR is not timely addressing grievances against doctors at all. And I had very good insurance, but had dealt with a prior “bad fix” on a broken bone and a confessed “Foul up” with a neuroleptic given to cover up the “bad fix.” And since I had good insurance, I ultimately ended up being medically unnecessarily shipped a long distance to doctors, who “snowed” me for profit, to cover up the prior medical mistakes to which I’d been subjected.

      One of those doctor has now been arrested by the FBI for having lots of well insured patients medically unnecessarily shipped long distances to him, to “snow,” (and actually perform unneeded tracheotomies on some of them) for profit.

      So sometimes access to healthcare isn’t always a good thing. Most of V R Kuchipudi’s patients were Medicaid or Medicare patients, which is likely why he was eventually caught. My medical research was only possibly why he had to leave the big hospital I dealt with him at, for a smaller one, where the FBI had an easier time spotting his crimes?

      https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CCkQFjAB&url=http%3A%2F%2Fwww.justice.gov%2Fusao%2Filn%2Fpr%2Fchicago%2F2013%2Fpr0416_01a.pdf&ei=PONTVcyTCMqdNuHKgcgO&usg=AFQjCNFZUC8OxCVtnXcVlirFEgjgYoUTTA&sig2=Qqlco-vhwZwYm61zzpLynw&bvm=bv.93112503,d.eXY

  6. For me therapy did help me to a degree but it was also extremely hurtful. In someways I feel like I was emotionally raped.

    I chose to trust this person with alot of personal stuff and before I knew it I realized I had opened up to a person who could care a less about me and I suspect was talking about me behind my back. Either she was completely incompetent or just a terrible person. Unfortunately through what you call smoke and mirrors they use your loneliness and vulnerability to get you trust them, using fake empathy and kindness to earn your trust. It really is almost the same thing as a predator taking advantage of a child’s trust.

    As far as I’m concerned psychiatry needs to be eradicated as a profession, no more making money off of peoples misery.

    The difficult part of it is because of psychiatric propaganda our society holds these frauds and abusers in high prestige. I’m studying Social Psychology, in the text it lists the most prestigious occupations, psychologists are seventh on the list even though the entire thing is based on lies.

    • “I chose to trust this person with a lot of personal stuff and before I knew it I realized I had opened up to a person who could care a less about me and I suspect was talking about me behind my back.”

      Thank you, this gives me clarity, I couldn’t quite put this feeling into words, but you did it nicely. Yes, it amounts to pure inauthenticity, and then betrayal.

      I also felt as though I were being talked about behind my back when I was in a day treatment center with a staff of therapists who OBVIOUSLY discussed their clients (us) among themselves, and not very nicely, from what I gathered from how they would run each subsequent group. I also naively thought they cared about their clients, I had no idea we were the nuts and bolts of a factory an endless and loopy assembly line that never really moved forward.

      “Either she was completely incompetent or just a terrible person.”

      I’ve had this very thought, too, about some clinicians with whom I worked, trying to decide which way to go on this. Either one is problematic, of course, in this field.

      A third option would be that this is simply standard operational procedure in that culture. A few years following my time in day treatment (which made me so much worse, really paranoid for a while, because there, we all had reason to be), I was a social worker and at those staff meetings, sure enough, the clients were talked about in derogatory ways. Not all of them, of course, but the more challenging clients pushed the staffs’ buttons, and they did not know how to take responsibility for this, and instead, projected all their judgments onto clients. It was very clear, suddenly, why I felt the way I did after leaving day treatment. This is an unsafe, very unhealthy environment. There is no empathy or compassion for clients, more like pity or scorn, from a place of ignorance. I saw this first hand, behind the curtain. This kind of childish nonsense helps no one at all, but this is who is running the show.

      I appreciate your perspective and echo your thoughts, thanks again for sharing.

    • Exactly my opinion about 99.99% of the psych professions. Either pill-pushers or manipulative or simply dumb – there are very few (only one I know personally) who have any qualifications (by which I mean empathy, goodness and willingness to help people and form honest relationships with them – not some degree from some school) to do what they’re doing.

    • FrayedEndsofSanity,

      “I was emotionally raped. I chose to trust this person with alot of personal stuff and before I knew it I realized I had opened up to a person who could care a less about me and I suspect was talking about me behind my back.”

      Same thing happened to me (I was eventually handed over the medical proof). Seems like that’s what the actual practice of psychiatry / psychology is all about within the mainstream community, anything to bring in business. But it’s sick to promise to “first and foremost do no harm,” then defame, discredit, and torture your patients.

      I’m sorry for what happened to you, my best to you. And make a difference with your studies!