No, Jill Biden Should Not Be Called “Doctor”… But Only Because No One Should


It was 2012(ish), and I was standing in front of a room full of peer specialist trainees offering a segment on language. We were deep in a discussion about how words carry power when one student raised his hand and inquired (something along the lines of) “What about doctors, and the inherent power we give them when we call them ‘Dr. Last-name’ while all the rest of us are called our first names. Should I be doing that?

My response was something like, “I can’t tell you what to do or not do, but I can tell you that I don’t call doctors ‘Dr. Last-name’ under any circumstances for precisely that reason, and…” As I began to further unpack the question and my response to it, another student from off to my left began yelling at me. Yes, yelling. He forcefully informed me that my practice insulted his brother who had spent many years working on becoming a doctor, and that I was disrespectful and abusing my own power as a trainer to even suggest such a thing.

Once he quieted down a bit, I was able to say this:

“This is not about disrespect. I need not be rude or denigrate any person when I refuse to refer to them by such an honorific. I do not speak to them in a dismissive tone when doing so. I am simply not contributing to the power imbalance that is created by elevating a certain sub-set of our community over and above everyone else, and particularly over those of us whose words and credibility become automatically devalued by this society when we are diagnosed.”

I then asked the student who’d yelled at me a question. I conjured Dorothy Dundas – one of the last living survivors of insulin shock and who happens to be local to my own state – into the room. I asked him why he thought that a doctor who’d, yes, spent years in school achieving that credential truly deserved more recognition and voice than a woman who spent years incarcerated in a psychiatric facility, who was subjected to insulin shock and saw her roommate die on the table next to her as a direct result, and who’s spent so many years since then working to be heard as an advocate?  Doesn’t she deserve respect and to be revered for all her years invested (involuntarily and otherwise), and all the wisdom she’s gained along the way, too?

My point wasn’t really to create yet another sub-set of humans deserving of being recognized. Dorothy is a powerful person whose story deserves to be heard, but not more than so many others. Rather, by conjuring Dorothy and holding her up as an example, I was simply attempting to put a face to a different type of experience and to highlight how relatively random and biased our culture is when it comes to whose experience it regards as valid, meaningful, and true. As we know all too well, “doctor” credibility routinely flies in the face of science, and respect for life and liberty of those deemed different enough to be diagnosed.

The student didn’t answer my question. He didn’t speak again for the rest of that particular class. I have no idea where he – or his brother – might be today, or if I actually impacted his beliefs or not. But here we are again, arguing about who should and should not be given some sort of elevated honorific with Jill Biden at the center of the debate.

On December 11, 2020 the Wall Street Journal made the somewhat strange and ill-advised choice to publish an opinion piece by Joseph Epstein, a man who self-reportedly taught at Northwestern University for 30 years with no more than a Bachelors degree to his name followed by an honorary doctorate awarded by an individual who was evidently fired from their post a year later. Joseph starts out his editorial with the following:

Madame First Lady—Mrs. Biden—Jill—kiddo: a bit of advice on what may seem like a small but I think is a not unimportant matter. Any chance you might drop the “Dr.” before your name? “Dr. Jill Biden” sounds and feels fraudulent, not to say a touch comic. Your degree is, I believe, an Ed.D., a doctor of education, earned at the University of Delaware through a dissertation with the unpromising title “Student Retention at the Community College Level: Meeting Students’ Needs.” A wise man once said that no one should call himself “Dr.” unless he has delivered a child. Think about it, Dr. Jill, and forthwith drop the doc.”

Calling a woman “kiddo,” and singling her out for her pretty standard use of the honorific “Dr.” is unquestionably misogynistic nonsense. Using language and such status symbols inequitably as a weapon to denigrate women is neither new nor even vaguely “cute” no matter how hard the author may try to utilize his wordsmithing skills to make it be. Shame on the Wall Street Journal for entertaining any of it.  The author’s use of this as a jumping off point for a diatribe about the problematic nature of honorary degrees is also bizarrely misguided given Jill’s degrees aren’t honorary. She earned them through several years of schooling, which is more than can be said for the author himself who must have a ton of social capital in his grasp in order to have secured such a long-term academic post in the world of “higher learning” and an honorary doctorate on a Bachelors alone.

With this in mind, Jill deserves all the defense she is receiving. However, this rush to defend Jill’s honorific usage is missing a much bigger and far more pervasive point: NO ONE should be called “Dr. Last-name.” And, I do mean no one.

2019 marked the first time in history when there were more female-identified medical students than any other gender, but the history is clear: Men have had far more access to achieving this level of education over the years. In turn, this means that men still outnumber women in the vast majority of specialty areas among practicing physicians. The same is essentially true of all doctorate-level degree programs. Women are starting to close (or even overcome) the gap in some areas, but that does not represent the full reality of who has had the access and resources needed to earn these titles and the respective prestige they afford, nor who is represented in related roles in our workforce. It does not change the reality of how different groups of people are valued in this society.

Black Tulane Medical Students in Article re: Jill Biden and Dr. Title
Group of black Tulane medical students pose on plantation grounds where enslaved peoples were formerly housed

The divide does not stop at gender. The vast majority of medical students are white, and the representation of whiteness among practicing medical doctors is quite similar. Disabled people make up – at most – only about three percent of medical students in any given class. Unsurprisingly, socioeconomic status represents another huge and intersectional divide, with more than three quarters of medical students coming from families of substantial wealth. And while I (perhaps to Joseph’s glee) am zeroing in at the moment on the medical version of doctor-related degrees, these disparities are reflected throughout the academic world, just like they are in society at large.

I realize it all gets pretty muddled and confusing. Supporting a woman or a black or brown person or someone who spent years locked up in a psychiatric facility (etc.) to be referred to using the honorific that most typically accompanies their educational achievements within society’s current context bears a sort of short-term “right” to it. However, it also seems quite myopic to me. When that whole academic system is rooted in classism, white supremacy, misogyny, ableism, and psychiatric oppression, should we really opt to be complicit with it at all? Are we prioritizing “micro” over “macro” at our own expense? Are we tacitly consenting to participation in a wildly dysfunctional and oppressive system for the sake of winning our few scraps? Yes.

Speaking specifically of the land of psychiatry, the chasm that exists between “doctor” and “diagnosed” is especially vast. Risks assessments have been demonstrated to be ineffective and even harmful, but people with “Dr.” honorifics (of all kinds) developed them, so they continue to be common practice. Forced holds are well documented by scientific research to lead to a rise in suicide risk, but doctors remain free to authorize them and do so regularly. Reports of positive experiences with voice hearing (and non-medicalized supports for those that are less than positive) abound, but no power structures exist to force any doctor of any kind to listen to them. Most of us stuck with psychiatric diagnoses have had the experience of not only not being heard at meetings about the intimate details of our own lives, but sometimes not even being invited at all. And who among us (at least in the United States) hasn’t seen how other clinical providers bow to the word of the all-mighty doctors in the group, no matter how misguided they are?

In psychiatry, “doctor” would best be defined not as one achieving a particular level of academic achievement, but as the one who spends the absolute least amount of time listening to and actually getting to know those of us in the “diagnosed” group, or whose knowledge of a particular situation is most inversely related to the power they have over it. “Least likely to show up to a training” or be open to new learning would also be a valid addition overall. And, as I watch other clinical providers fall all over themselves to refer to those doctors as “Dr. Last-name” while everyone else goes by their first name (using their own power to further enhance and perpetuate the “doctor” power that is wielded over us), I’m constantly reminded of these facts.

Yes, Jill Biden should absolutely be defended from this blatantly gendered attack. But, when you’re done defending her, let’s dismantle this whole honorific practice altogether. You can start (for free!) by applying first name usage equitably across all people and roles. The greater the power and privilege you currently hold, the greater the responsibility you have to participate in this process of undoing. (Read: Do not expect the burden of this effort to fall on, for example, black female doctors who may justifiably be prioritizing recognition as Dr. Last-name to counter rampant racism and the routine lack of recognition and respect they have suffered for years. If they are the last in line to let that honorific go, we will have done this right.) Internalizing this oppressive system continues to marginalize so many of us, and to reinforce a capitalistically-driven way of existing where credibility even about our own lives is bought rather than assumed as a part of our humanity.


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.


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  1. I have a very hard time getting really getting involved in this argument, which seems to be mostly about leftists and rightists finding yet another excuse to attack each other. Personally it makes me feel good to call a physician by the honorific doctor simply because that term means they have achieved a certain educational level that should make me, hopefully, respect their opinion. If someone with a ph.D gets a kick out of referring to themself as doctor, I really don’t care, and I don’t think it elevates them or demeans anyone else to do that. I do get a little more riled at calling someone misogynistic simply because he used the future First Lady as a way to criticize the term doctor and because he used the term kiddo (apparently because that’s a term president-elect Biden has used to refer to his wife). I think it wasn’t the smartest way for him to start his article, but do you know how many dumb things I read every day? Maybe we should all calm down and not be so sensitive about truly unimportant subjects.

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    • As to whether it is “sexist” or not, I think the question to ask is, have you ever heard this kind of argument being used to tell a man not to call himself “Doctor?” And how would it fly if a high-ranking male cabinet member were called “kiddo?”

      It is, at best, intentionally demeaning. Of course, I don’t call my doctors “Doctor X” anyway, so she wouldn’t be getting that honorific from me, but I wouldn’t try to rub it in by writing an article or do a TV bit about it!

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      • Lots of people are saying the term doctor should not be used by Ph.Ds, including Sera Davidow. So yes this kind of argument is being made to tell men not to call themself doctor. As for the word kiddo, again, Joe Biden used it to refer to his wife and the author of the WSJ article was simply referencing that. By doing so, Epstein certainly wasn’t being deferential. But treating high ranking individuals this way has become commonplace. Now you (me too) wouldn’t write an article on this topic, but Epstein and the WSJ do seem to know how to get attention.

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        • I meant in a large public forum like the WSJ. I know there are plenty of people (like me) who don’t think getting an advanced degree confers some special status on you that entitles you to a special name. But purposely writing an article in a national journal saying that someone shouldn’t be called “doctor” specifically because they’re the First Lady smacks of sexism to me.

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      • High Ranking? I think you might have just gotten swallowed in the aura of the image? For to understand the internal language of the elected, the civil servant and what can be said and not, in an “orderly” manner by prescribed process is the beginning for learnign how to become “an anonymous source” as reported.

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    • Marie,

      I gotta be honest that your response here seems really strange to me. One of the links I included in the article above is to research specifically about how much more frequently women are *not* called by their Dr. honorific than men. In other words, there’s a pretty solid and documented history about how this is rooted in sexism. You can deny that – even in the face of this man calling Jill ‘kiddo’ (her husband calling her ‘kiddo’ is a little odd sounding to me, but nonetheless exists within the context of an intimate relationship and is totally different than a stranger taking such a liberty) – but it doesn’t make it less a real thing.

      As to the rest… it reminds me of this: There are many people who say ‘just because the system was oppressive to you,’ doesn’t mean it was ‘oppressive to me.’ And what I say back to them pretty routinely is, ‘Just because you didn’t feel directly impacted by systemic oppression, doesn’t mean it doesn’t exist.’ In other words, systems either are or are not oppressive… How people are individually impacted by that doesn’t really change things.

      I also don’t really get the leftist vs. rightist argument you’re making, but that’s okay. I’ll leave my response at this for now! Regardless, thanks for taking the time to read even if it did not resonate.


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      • Sera, my main point is that women are STRONG. We do not have to obsess over a relatively unimportant article that would have received no attention if it had been written about a man. True misogyny is obnoxious. But to keep looking for it makes us victims and is disempowering. As for leftist vs. rightist, well Melania Trump was often disparaged and I saw very little liberal concern about that. I predict that the same kind of attacks on Jill Biden will not be overlooked.

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  2. I dunno. Doctor Trump does have a rather objective clinical ring to it (I did spell wring correctly?)

    Because I was musing about this and realized I had completely forgotten what this had to do with Jill Biden…..


    The last time I used the prefix “Doctor” it was to exemplify how someone goes and gets a badge because they really can’t support their “teachings” without it: stuff that wouldn’t stand by itself – I obviously use the word stand loosely, that while when you replace the word go from the phrase “go to class” with stand or sit, it pretty much points out one’s status –, the same with the term “Professor.” In fact, when I used that adjective – not title – a policeman in the parking lot where I just exited the bus heard me, and responded: “He’s jealous,” which unlikely referred to the one with the prefix. But then anything with fix in it might already be inappropriate.

    Saddest thing, is that those who were here to begin with, and knew the land, knew nature, knew the seasons, knew the stars; they are even more likely to be killed by police than Blacks, and that’s mostly from safety checks by the police regarding “mental illness.” It’s those people that had knowledge then that we all need to know by now, and…..

    But yeah, you can say: “Doctor” or “Sir” or “Professor,” or even “President” and really mean obnoxious loudmouth, with perhaps no one the wiser.

    Here’s then an actual tweet shared from a Doctor, which might denote something different than the prior (very obnoxious) interpretation of mine

    And just in case anyone is quite confused by now. If such a wise one gives you a test, and you have to chose between, A) adjective, B) title and C) prefix regarding what “Doc” is, and you really need the right answer for him, it’s C. That’s because he (or she) is a professional. And don’t tell them it’s what you call a document, and could be the extension for a word processor file, being that it’s the way documents are filed on a computer, he doesn’t need to know you know that, he might not understand, he’s just too busy, consequently he might think you completely don’t know what Doc is.

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    • “The last time I used the prefix “Doctor” it was to exemplify how someone goes and gets a badge because they really can’t support their “teachings” without it”…

      I think you’re referring here to how credibility is sometimes much more about power and social capital than it is about being in possession of real quality information, and with that I couldn’t agree more.

      Thanks for reading! 🙂


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      • Yeah, but that’s perceived credibility and can be downright brainwashing regarding whether what’s perceived truly is credible. In response to: “I think you’re referring here to how credibility is sometimes much more about power and social capital than it is about being in possession of real quality information, and with that I couldn’t agree more.” And it’s often not low quality information or even lack of it, it’s too often deceptions, modeling arguments with statements that look like they are formulated: as in A plus B equals C whether or not A plus B equal anything at all but it sounds good, and scientific and logical; and quite covert lies covering up the truth, which is known to a select few.

        I really, in becoming part of the marginalized crowd, after years of actually looking quite soberly at what goes in the arena of condoned knowledge, and really carefully sorting through alternative information as well as personal experiences, I find an incredible amount of what goes on at educational institutions quite corrupt, particular higher learning where one gets a profession or not with a paycheck. That doesn’t mean there aren’t good teachers in there, but they have to know how to play the system, or they have somehow got a name for themselves which can’t be ignored. This type of doling out “knowledge” also goes for religion promising an afterlife, or the image of being a good person, or as you mentioned in another post their description of “God.” That’s also mind control, to tell everyone they are under attack by said evil entity (the Archfiend) and you need the church or you’ll end up in the lake of fire for eternity when not part of their movement, is the same as what all dictators have done knowing when you make people think they are under attack you can control them. And for the corporate process, how they have suppressed whatever doesn’t go with their profit margin, and an unbelievable amount of wonderful truly amazing technology using the idea that it’s impossible in order to convince people it’s fraudulent when it isn’t, while suppressing it ever being put into production for the general public to find out and robbing mankind of really amazing stuff….

        Maybe I’m just jaded, but…

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  3. Interesting Post, though if I had been in your training class in 2012, the observation would be made and the question raised regarding the use of the word, “Trainer”. In the past the term was used while studying labor in a Master’s Program and my mentor would correct me, to offer that one educates a human being, that one the other hand, one trains monkees. Trying to learn the nomenclature of a different profession requires a great deal of effort if one is wanting to really enter the conversation, either in writing, speaking or just being present to the discourse. Within the family experience, there were several aunts and uncles. From your logic, would you suggest all prefixes be tossed? For in understanding a healthy conversation, that embraces the other(s) while carrying on, may not be as tied to the institutions that sanction with diplomas, but rather the degree(s) of intimacy by which one gaines insight into LIFE. Please elaborate more on how and why one “should” rather than “shall” follow your philosophy as oppossed to another?

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    • Bill,

      Semantical arguments over words like ‘trainer’ vs. ‘educator’ may capture my or other people’s interests, but have little bearing on this particular conversation. We all have an array of roles and/or jobs in our lives, and while we could get into conversation as well about the inequities in that arena it’s not quite the same as talking about roles that are only accessible to a relative few (due to classism, ableism, racism, sexism, etc.) and that give people elevated titles like ‘Dr.’ as well as elevated reverence and credibility that is all too often unearned. Moreover, Dr. – at least in the psychiatric realm – also comes with a whole other layer of power over others beyond simple credibility. In fact – it is Dr. (both medical and non-medical) who typically also has the power to order us incarcerated in a psychiatric facility against our will. And while it is not the honorific alone that allows them that level of control, its all tied in.

      I’m not sure what to say about your question in regards to ‘aunt,’ ‘uncle,’ and so on. It honestly seems a strange direction to go in here. Regardless, thank you for reading and taking the time to comment!



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      • To type an argument or to hear an argument is more than semantics. Typing is not a conversation, as we have known but a different form of word search, to attempt to find a word that even fits the silence of a keyboard that may not be so beautiful as a typewritter. In someways, to assume “We all have an array ….” to me identifies a false assumption. Many may not or do not have an array, in a world that assumes everyone thrives on connecting into the machine. Texting, typing, zooming, etc. is not the same as having a front porch conversation where one really gets to converse. To talk about power, as in political or social, or to underand what matter is made of as a structural challenge is mind boggling and very difficult for any conversation.

        But I think to say “You should …..” can be just misleading. Each one of us is challenged to forge our way in a world that can be brutal, though questionable more so about the extent and recognition for “Rights”.

        Thank you for taking the time to comment. I would rather engage in person, as to learn how to speak in a forum, which I have realized at times, is physically becoming maybe more on the edge. What I have wondered and increasingly so, is how so many think they can get away with murder? For in the collective since, we die one at at time, though our situations can be occurring directly as well as indirectly form issues that evolve from abuse. The brains along with the beutiful thinking by which we attempt recovery need a better way to affirm we are human, no different from the “higher levels”…

        Further to understand the role of education as perceived and being articulated by which a motto might be aspired to, to begin to learn about the power of thinking, even thinking about thinking can be a real challenge.

        Too, if language itself is concretized, when accessibilty is yet to be chisled out of the reality(s) held that keep certain people from entering the temples of exchange (assumming we are entering a knowledge based economy), then at what point or how does one discover the markets by which applied thinking and conceptual are received and validated?

        Could the thinking be skewed to think that psychistrists are the only ones prescribing psychiatric medcines? Would you rather just pull a directory of names from a shelve or google that suggests presence without reference or clue to who might have stronger qualities for working in certain realms?

        As regards to the process of being incarcerated against our will, to experience that process, there can be many players. To go before the judge, who may not be an LLD, withou to much comprehension of medicine, the tragic nature of meeting a public defender for 5 minutes before a hearing when one is medicated to where the words do not come easily is a bit of a problem that needs to be addressed.

        With reference to the aunts and uncles and so on, though perhaps strange, imagine what is means for a child to experience their relatives first as Uncles and Aunts, as an address of respect or should you do away with that reference? For to grow from being a child who experiences cousins with parents who practiced in the medical community were more than a “Dr.”. With an education or not?

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  4. In some ways, categorizing and comparing people for any reason is going to create winners and losers and haves and have nots, even if it’s some elusive, unwritten rules and regulations about how best to treat people. Jesus even admonished his followers not to call anyone “teacher” or “father,” because, “You have One Teacher… and One Father who is in Heaven.” Some honorifics are so common that perhaps people don’t think much about them.

    In some ways, I really don’t care if I have to call my current psychiatrist “Dr. Last Name,” as long as he continues helping me off of psychiatric drugs, and doesn’t make me go to the “hospital.” Maybe that’s being submissive. I guess I would rather be submissive for a time, rather than end up in a “hospital,” institution, “community housing,” homeless shelter. Negotiating social interactions can be so complicated.

    There is this saying, I am not sure if it originated in Catholicism or not, but I heard it at Church one time, that we are called to comfort the afflicted and afflict the comfortable. I kind of like that general rule of thumb. On the other hand, someone who appears to be too comfortable may actually be afflicted in some horrible way.

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    • Caroline,

      It’s interesting that you bring religion into this. Honestly, what that brought up for me is this: I don’t know much about religion. I’ve pretty much always steered clear. But when ever I’ve heard from people who believe in a brand of religion that talks about ‘fearing’ their god or their god punishing them for not believing and being faithful, I find myself wondering what kind of god would be so angry toward people simply because they weren’t referent toward that god as much as that god would like? It certainly didn’t make me any more interested in being connected to at least that religion, and I surely hope – if there is a god of any kind – that that god has far more compassion and kindness than that. I guess I feel similarly about doctors. If they are so attached to their honorifics that they feel the need to be called by them or not let go of them for a greater good… Well, then, that’s not a doctor I’d want to follow, either.

      In turn, I’m also reminded by someone with whom I’ve worked a fair amount over the years. He was speaking on a stage to a room full of people who have the experience of hearing voices, as well a to clinicians and various other providers, family members, and even a commissioner of a particular state’s department of mental health when he decided to tell a joke… The joke went something like: What’s the difference between God and a psychiatrist? Answer: God knows he’s not a psychiatrist… I was a little nervous as to how some of the doctors and DMH officials in the audience might react, but people seemed to receive it well. :p


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      • I quite agree with your sentiments about religion. There are certainly plenty of people who do believe in a cruel and punishing God. I have wondered about that myself sometimes. Although I do believe in a loving God who doesn’t expect people to be “perfect” or religious or anything, there is still this problem of the suffering that exists on this earth. If God is so loving, then why? Sometimes I think that so much suffering is man-made and doesn’t have to exist if we were all just more loving. On the other hand, there is the fact of things like the loss of loved ones, natural disasters, etc. I really wrestle with these problems personally, and don’t have any great answers. In my ideal vision of God, though, in the times when I do believe in God, I feel that he does love everyone, even though I have no good answers about how a loving God could allow so much suffering.

        That is so funny about that joke. I have actually been trying to work on an essay about the god-complex of psychiatrists. If God is indeed a cruel and punishing God, then who could better represent him, but psychiatrists?

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        • Yes Caroline, that is just it. The “representation” has always been representation of power, through whatever means people can muster.
          Psych is a replacement for what ruled before. And no, they did not advance in “knowledge”. It’s never about knowledge, it’s core is bias and discrimination.
          It’s a rough terrain out there.

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  5. I feel rather odd commenting on this one. There are some things in this article in which I disagree with the author. I do have several relatives who have received doctorates in humanities type subjects and became college professors. They liked to be called “doctor” but always acknowledged they were not medical doctors. Personally, I think the entire education system, especially higher education creates a real caste system. It seems all important to some whether they have any type of degree beyond the Bachelor’s. They seem to rate themselves on their degree status and even how many degrees they have. I try not to judge someone on their alleged degree status. I have known intelligent people without any degrees and those not so intelligent who have degrees. And there is also that divide between those who consider their education as received through “the school of hard knocks” and those who received their education through “ivory tower book learning.” Personally, I only received a Bachelor’s degree and when I tried to go to graduate school, my stomach would hurt and I would then run as far as I could from that kind of environment. For years, due to the drugs and therapy, I was made to believe it was because something was innately wrong with me. Ha!
    Now, I know it’s really because all those “doctors” were “witch doctors” and it could be that more and more doctors of all types, especially medical doctors might be seduced by that kind of “dark magic.” Thank you.

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    • “And there is also that divide between those who consider their education as received through ‘the school of hard knocks’ and those who received their education through ‘ivory tower book learning.'”

      Good point. And in this very corrupt world in which we currently live, perhaps the holier than thou “ivory tower book learning” types should start listening a little more to “the school of hard knocks” types. Especially when it comes to the psychiatrists and psychologists.

      Reinforcing “a capitalistically-driven way of existing where credibility even about our own lives is bought rather than assumed as a part of our humanity.” I’d call it more stolen, than bought. Since I had to leave my psychiatrist after he tried to claim my entire life to be “a credible fictional story.” Not to mention I ran into another psychologist who attempted to steal all my work and money, because my work was “too truthful” for him. And I’m unaware of anyone whose been harmed by psychiatry’s systemic – and massive in scale – malpractice, ever being paid for that malpractice. I call that theft.

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    • Rebel,

      I would certainly agree with you that the whole educational system creates a great deal of inequity. As far as I’ve understood, countries that have free ‘higher’ education have significantly less class differences throughout their culture and that seems like a good thing… but it’s certainly not where we’re at in the US.

      Thanks for reading and taking the time to comment. 🙂


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  6. Lately, having been in contact with doctors and nurses reading this article i do come to the conclusion that some people are academic and some people are hands on. Those who are book worms and academics go onto become doctors and professors and teachers and rightly so. Medical doctors are in the business of care. Also they have to be hands on.

    When you refer to a medical doctor by dr ‘surname’ and rightly so you are addressing a professional with the respect they have presumably earned by qualifying not only through being an academic in their field of expertise but by years of experience as hands on.

    I found myself that I came to refer to the doctors I encountered as dr ‘first name’ and this was not just recognizing their skill but recognizing it with affection.

    I am diagnosed and i am not educated so the there is a status of superiority between me and my psychiatrist. I was given my diagnosis without being asked if i agreed with this or not. However, this does not make me feel inferior or at a disadvantage. In fact lately it makes me feel so grateful that what i do in fact suffer from is recognized.

    This now i do agree with and am grateful for and the polite address to the doctor who has treated me is no skin off my nose

    Misogynists are to be found everywhere they are just a daily irritation for educated women in every profession. Women in position usually are made of tough stuff and can take criticism from men so the little quip Epstein gave to Jill Biden ‘kiddo’ i am sure she brushed off quite easily.

    I took on the identity Mrs when i married. I was happy to do so. I think that having the title doctor is still quite acceptable and should remain for some time to come. After all both are forms of identity and along with by diagnosis bi-polar people like me and others need to be identified. thank you!

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    • Bippyone,

      At least in part, I would respond by saying much of what I already wrote out to Marie… Just because it has not impacted you, does not negate the issue at a systemic level. I guess I also find myself reacting to the idea of ‘politeness’ in this context. As someone who has watched quite up close and personal hospital staff (for example) bowing to the ones with Dr. titles at the expense of some of the most vulnerable held on those units I feel really clear that the power imbalance tipping so strongly in their direction is incredibly harmful. I do not owe them any extra reverence or politeness over and above what I would offer anyone else. I would also point to the paragraph where I wrote about people with Dr. Last-name titles often being the ones who don’t show up for new learning and whose power over people is most inversely related to their knowledge of them as an example of how off kilter it all can get. And while – as I’ve said in other comments – the use of the honorific is not responsible for all that, it is a really visible symbol of it and the easiest starting point for things to change. Honestly, I find it bizarre that so many people are resistant to the idea that doctors deserve no more reverence than so many others in our world, and that it is essential that we begin to chip away at the imbalances.

      Thanks for reading and commenting!


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  7. Sexism and racism is not the problem but are caused by the problem. The Dr. usage is the advancement of a logical fallacy. Appeal to authority is a logical fallacy. Evidence, data and logic should be the basis of an opinion not the perceived “authority of the speaker”

    When I show people that the evidence and scientific studies show psych drugs cause only harm a common response is “listen to your doctor” This response means “reject the evidence it is our final and most essential command.”

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    • If I remember my College Logic Class Correctly, the logical fallacy is appealing to authority. Either the only real authority is the person or God. If it is the latter, in Christianity to appeal to human being as an instead of God is a sin. You can not serve two masters. As far as the former, appealing to an authority outside of innate personal authority gained through life experience and self-education is just plain ludicrous and dilutes the inherent and irrefutable sovereign nature of both the individual and of God.
      Your note about the most common response being “listen to your doctor” meaning “reject the evidence it is our final and most essential command” can also be rephrased as “My Mind is Made Up. I don’t listen to the facts.”
      This is just the fallacy of fear or “False Evidence Appearing Real.” If the Question in a Multiple Choice Test is “What would be or is the Most Dangerous?” the only correct answer is: “All of the Above.” Thank you.

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    • Willowweed,

      “Evidence, data and logic should be the basis of an opinion not the perceived “authority of the speaker””

      I certainly agree with this… though I’d also argue that ‘evidence’ itself is so often manipulated and/or rooted in a system that privileges those with a lot of money (to pay to gather and interpret the evidence) that I feel cautious about that piece as well!

      Thanks for reading and commenting 🙂


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    • Fiachra,

      I tend to focus most of my critiques on the system that drives, pushes, and pulls all the roles within it rather than the individuals within it, but I hear you. A ton of harm is for sure being caused.

      Thank you for reading and commenting!


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  8. Hm, I am a gardener by trade. I have a client who is a doctor, a consultant in ICU as it happens, which means he is of importance in treating server coronavirus cases at the moment. I call him Andy as that is what he seems to want to be called. Although it must be said I call him Dr Andy to my friends as he is rather cute and I harbour a Chic Lit fantasy of him rescuing me as I mow over my toes one day and we miraculously end up married – sigh, one can dream. Meanwhile I need to order some aconites for his garden (not to mention getting a life…)

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  9. Sara, congratulations on this effort to promote fairness and equality. However maybe your missing the point and overgeneralising from your experience of psychiatry. Question, would you ask Joe the plumber to diagnosis your aches and pains? I feel confident you’d go to a suitably qualified physician.
    Has anyone here actually studied for a doctorate, it’s hard going, and the honour, and it is an honour, is a testament to intellectual effort and rigour- we’d still be living in caves without people like this. People who’ve gone through a rigorous process of research and education to earn a Phd have every right to have it recognised. And have their expertise recognised, in their area of expertise. My but theres an awful lot of distracting nonsense going around these days.
    However Sara, please do keep honouring the struggle for fairness, equality and respect but also maybe we need to respect professional expertise and maybe be especially respectful when they get it so spectacularly wrong as they do in psychiatry. I’m not entirely convinced they know what their at despite being presented with daily evidence that they know what their doing!

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    • I would say that I DO respect professional expertise whenever it is demonstrated. The problem is, a doctorate is neither necessary nor sufficient proof of “professional expertise.” I’ve know PhDs and MDs who were so incompetent and/or malfeasant as to be extremely dangerous, and I’ve known volunteer crisis line counselors who were incredibly capable and successful in helping their charges consistently and effectively. I don’t really see a direct relationship between training and professional expertise, especially in the “helping professions,” and the pretense that such a relationship exists is part of why the current system fails so badly. I mean, why would someone trained as a medical doctor be expected to have ANY expertise in helping people with emotional/spiritual/behavioral problems they might identify? Let alone the expertise to “diagnose” such people according to the subjective and largely arbitrary rules of the DSM? It’s kind of like hiring a plumber to repair your car.

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      • Indeed the fact that somebodies expertise is earned is no reason to assume they always abide by it. Most people presumably are happy with the service they receive from plumbers, mechanics, physicians etc.
        The problem with psychiatry might be brought further into light by realising they have trained as experts but the expertise they possess, such as it is, does not equip them usually to work with people to develop a meaningful life. It’s aimed at containing the troubled and/or troubling person. Pharma have been exploiting this fact at enormous profit for decades now. And it’s got to the point that many of its victims are not particularly troubled!

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    • Whatuser,

      I’m honestly perplexed by how stuck on wanting to ‘honor’ the efforts of a particular sub-set of people you and others seem to be. No one – myself included – has suggested that there isn’t a lot of work involved in getting through a particular degree program. However, do you really believe that that effort is consistently greater than, say, the effort put in by so many people doing so many things? Ableist ideals about basing our worth in what we can ‘do’ aside, are there not many people working very hard in this world? Perhaps even more importantly, does the salary afforded to many people with the honorific of Dr. not suffice in terms of recognition and honor? I realize that salaries will vary among the doctorate crowd, but really… So many of them (according to research) come from money and go no to careers that earn them much higher salaries than most of us… Is that not enough?

      Let me put it this way: Let’s say I’m wrong, or at least exaggerating the impact of a system that elevates the title (not just in work but across all areas of life) of someone who has earned the honorific of Dr. in terms of power imbalances and the systemic oppression of others… What on earth harm would be doing by getting rid of that system? At worst, the action would be neutral. (No one has been able to provide an even vaguely convincing argument that the actual earning of the degree, the salary that tends to follow, and one’s ability to hold an actual doctor-related role is not enough to ‘honor’ and ‘recognize’ their efforts, with the exception of those who’ve argued its important *within the current context* for people from marginalized groups to claim their titles as an anti-racist, anti-sexist, etc. act… But again, that’s within the context of the existence of the honorific system, and not its having been dismantled…) At best, it would be a concretely attainable step toward undoing oppressive power imbalances that elevate the voices of those who’ve completed academic learning so far over and above those who actually work more directly/frequently with the humans over whom that power is most regularly wielded, etc.

      Plus all the other things I’ve said in my other comment responses…


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      • Actually Sera you are writing words that I recall myself as saying. So we probably agree on much of the same thoughts about how psycho-socially disabled folk like myself are mistreated, discounted, discriminated against, deprived of resources – it would be of enormous worth for those resources which are set aside to be more properly deployed to help us directly or ensure that people are employed to work with us to develop more meaningful lives for ourselves. Still don’t see the harm in according the title Dr. To those who’ve earned the accolade any more than according the accolade plumber, electrician, nurse, mechanic, dentist to those who’ve earned their skills with hard study and effort. Actually alot of people’s identity is very tied up with their work.
        Maybe I’m missing something (I’ve had long conversations with people about the misuse of the concept of ‘helping’ people in distress wherein the people failed utterly to comprehend the point(help can be welcome but a helping attitude can be cloaking the sense of superiority, one that feels no obligation to understand ie. its more akn to colonial attitudes) ) but consider the possibility that you are barking up the wrong tree with this. Better to focus on the major fact that psychiatry ignores – People aren’t disordered, we are distressed. We have no known etiology of disease, disorder, illness but suffer mental distress because of what has happened us, because of what hasn’t happened, because of what is happening here and now more often than not. These events can colour our psychology, our attitudes and make it difficult to get by until our attitudes change but the events, how we interpret them, our powerlessness over them are the key ingredients to understanding our distress. And appropriate resources the key to solving what seem intractable problems.

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        • Whatuser,

          I’m not sure if you’ve read any of my other writing on here. I certainly don’t expect you to necessarily have! I just wonder because I have certainly focused at length on the misplaced medicalization and oppressive nature of the psychiatric system in many different ways. That said, the honorific system and the power imbalances that it makes visible play a role in that, and so I don’t think this is irrelevant. Rather, I would say that this is one of the quickest, easiest ways we could begin to dismantle those power imbalances and show our commitment to undoing the larger problems. I would also echo what Steve has said above.



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          • Actually Sera, some of the writing you have produced should be printed in the Guardian, the New Yorker or the New York Times. It’s the sort of work sorely needed in these sad times. It’s clearly written, well researched and of significant public importance. As should some other people’s pieces here such as Bob Whitaker’s.

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  10. Whenever I hear an “ism” attach to something I cringe. Whenever, I hear something is “systemic” I cringe. Whenever, I hear higher education should be free, I cringe; although I think the price people pay for education is way too high for what they receive in return. As far as religion goes, fearing God is not fearmongering. The latter is created as a malicious to keep people in line, whether it is one or many. What my studies in religion have taught me is that God doesn’t so much as punish, but usually discipline. But, there does seem to be evil lurking that does need impactful punishment. When a person knows what is good and what is evil and choose good over evil, it makes life easier. And some may disagree with me, but there is only one way to discern good from evil and that is by knowing God. Thank you.

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    • Rebel,

      I’m a very spiritual person and think on this a lot, especially through Carl Jung’s work on these ideas. I would just like to say that God had placed the snake in the garden (evil existed before creation of humanity), Yahweh radically and unjustly punished Job, God forsook Jesus on his cross (a cross that doesn’t seem to be simply the Roman Empire’s doing), seemed fully comfortable debasing homosexuals to Hell—on earth and in the hereafter, and that it was God who unleashed the Seven Plagues. All this tends to highlight God’s wrathful and vengeful side, a side which perhaps Jesus tried to reform, or provide as an incarnation where God tried to offer ‘His’ right hand. I’m very wary of God’s ‘discipline’, as I’ve been abused in its name by certain ‘Christians’ and see the ‘punishment’ (often unjust) throughout history, society, and biology. The degree to which something is deemed ‘God’s doing’ vs a person/society, is notably difficult.

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      • I am sorry that you have been abused by anyone, no matter their religious beliefs. Sadly, abusing others in not restricted to adherents of any one religion. In fact, there is much argument on this website that psychiatry has created its own cult religion and as well documented by many on this site, psychiatry seems way too adept at abuse. Respectfully, I disagree with much of what you say about Christianity, but I respect your opinion and experiences. You do bring up some interesting points and questions about Christianity, God and Jesus, etc. I think that points you bring up would receive a more educated rebuttal from someone more studied in these matters than I am. However, after my life experiences and particularly my “rabbit hole” trip into the morass of psychiatric drugging and therapy, I stand by my belief system more than ever. But, I am not so naive as to expect everyone to agree with me no should they. The twin word of Freedom and Free Will apply here. Thank you for courageously expressing your opinion. Thank you.

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      • evanhaar – I’ve been watching the excellent BBC series “Good Omens,” written quite tongue in cheek by Terry Pratchett (RIP) and Neil Gaiman. I read the book in the 90’s, but am enjoying the movie/mini-series version.

        What stands out to me most on this viewing is that the “Sides” = “good” and “evil” are more about “delight” and “disgust” and the Angel Aziraphale and the Demon Crowley are the enlightened ones, saying, “Why can’t we all just get along?” “Why must there be a war?”

        Even the “good’ side says, “there must be a war so that we can *win*” Sigh.

        I recommend getting ahold of this miniseries and enjoying!

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  11. I am wondering what this is doing in MIA? What this actually has to do with psych – iatry or -ology or the suffering induced under those. I admit that those who prescribe (and the legal gateway which allows them to do so because of the papers they hold) are involved in a power imbalance – but – this article seems more political and social – or even linguistic – than is appropriate for MIA.

    So – I will tell stories. My father was the first in his family to even attend a university. His family came out of Kentucky poverty, and he was determined not to perpetuate that poverty in his own family. He grew up during the Great Depression, and remembers his shell-shocked and gassed WW1 father drinking the money that his mother tried to hide. He remembers standing in line to get shoes, ashamed that he had to beg for them. Doggedly, he pursued education, and after about a dozen years of university, earned his Doctorate in Business Administration with a specialty in Business Communication. We called him Doctor; he earned this. It was more than a piece of paper, it was his growing identity. Something which made him stand out from the pack – his family, his friends, he achieved all of this on his own.

    He worked as much as possible to pay for these degrees – a Westinghouse refrigerator factory, selling tires for Firestone, butchering chickens for his local grocer…

    Those were different times, but he worked hard for that “honorific” (as Sarah calls it), and so – we used it. My chilhood friends called him “Dr. Name,” as well as his colleagues. He was Dr. Name his entire life, and his achievements in his field never hit the New York Times or WSJ, but in our community he made a difference. He built up his faculty and developed one of the best undergraduate business schools in the state. He never got credit for it, never got called “Dean,” even though that was the last honorific he wanted. (My brother made sure that the title “Dean” got into his Obituary, to honour him.)

    Using his title “Dr.” was a way of respecting what he had been through – not only his education, but his roots and life experience.

    But those were different times.

    In my time in Bloomington Indiana – it was an appealing little town, and many people who graduated Indiana University wanted to stay and live there, even though there were only a few jobs for the highly educated. So in this IU town, there were PhD’s waiting tables and swishing toilets. Did we call the wait staff “Dr. Wait Staff”? Or the janitor “Dr. Janitor”? No, we did not. There were a lot of hidden PhD’s in that town, managing grocery stores, running call centres, selling cars, and yes, washing floors.

    In today’s society, the essentialness of a degree has been emphasized – for even simple jobs, a university Bachelor’s is minimum requirement. And the related student debt has, therefore skyrocketed. (this is a crisis of national proportions, and eliminating student debt is not something that the Powers That Be will consider, even though it is a burden that all society will bear.)

    Is it a meaningless piece of paper? Some would argue yes. But I know that my piece of paper was earned, and I am proud of it, and pleased at the opportunities it has brought me, even when I am not utilising them in the way I thought I would when I was a bright eyed, idealistic young student.

    Lastly, in this era of pandemic, I get disgusted at chiropractors who call themselves “Doctor,” when I know that their degree was probably easier than mine. In this era of pandemic, there ***is*** a difference between an MD or DO, and a practitioner who took weekend seminars to become an ND or “functional medicine practitioner.” In this era of pandemic, I do not want to take medical advice from a Doctor of Psychology (for example). In this era of “bro science” it is difficult to separate the wheat from the chaff, and I am more inclined to listen to The Paleo Cardiologist or Dr. Peter Breggin than I am Pete Evans or Pam Popper. That MD is a bar, and the minimum required to leap it is an important measure.

    So – in this era of pandemic, do we wish to distinguish medical doctors from doctors of chiropractic or PhD’s in Education? I know that we are more than the letters after our name, and some of them seem to be ego stroking – but many of them are, indeed earned.

    I do subscribe to calling medical doctors that I am fond of, “Dr. Firstname” – but there are some MD’s in my life that I respect too highly to even do that. My GP is one, my osteopath (who is also an MD) is another. They are, and always will be, “Dr. Lastname.”

    Linguistics, words do matter. And there is a power differential in psychiatry as well as psychology that is frequently abused in the name of DSM and diag-nonsense.

    But to revoke all honorifics seems like a broad brush, and throwing out the baby with the bathwater. I’m with Marie – is this really vital to our society? Or would it be better to house the homeless, feed the hungry, educate those who want to learn? I’m thinking of the principles of harm reduction, where this first world problem of worrying about honorifics has much less effect than taking care of people in crisis and in need.

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    • Jancarol,

      This isn’t a “zero sum game” as some like to say. We can care about things like hunger and housing, and *also* care about how deep the power imbalances run in some of these systems. Of course doing away with honorifics isn’t nearly so important as doing away with lack of food and housing resources. But why would that preclude us from talking about honorifics? It kind of feels like a strawman argument to me… this suggestion that that is any kind of counter argument to what I’ve offered, rather than a different argument altogether.

      Some questions for you:

      1. Is there really no other way to communicate who has completed a type of education or holds a license for a particular role beyond honorifics? This also seems like a strawman to me… I never said people should deny or hide their roles… just not be referred to in all aspects of life by that role (even when they’re not doing anything even a bit related to it!).

      2. Do you truly believe that any honorific is actually needed, and if so why? What do you think the honorifics really accomplish?

      3. Do you know of any other completely free and widely accessible way to begin to chip away at the power imbalance between ‘Dr’ and the rest of us?

      4. Maybe you think that the power imbalance the honorifics represent (both in access to education and in credibility/power in the moment)… but then, what harm would it cause to do away with them nonetheless? If they do no harm, still no harm done by not having them…

      Your stories are valid, but I’m unclear how they support an argument to continue the use of honorifics. Much of what you talk about references the inequity to access to education, and as I said in the piece above and in the comments section, within the context that currently exists it may indeed be extra important for people who overcame marginalization to get their degrees and thus represent that by use of honorifics. But would it be important to have a different title if the honorific system was not what it currently was? Because *that* is my argument. That the honorific system is a part of an oppressive system and should be done away with, which would change a lot of the other pieces. People could still get their ‘pieces of paper,’ and have and speak about their jobs… no honorifics would not change that. But it would immediately change how elevated they are above so many others who have also worked very hard in their lives.

      I said this in the comments section over on Mad in America’s Facebook page, and I’ll repeat it here:

      Oh what a world we would have if we could manage to find ways to recognize and celebrate each other’s accomplishments without needing to step on others to do so…


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      • Sera –

        I did not state that honorifics should or should not be used.

        i merely told stories of times they are used, and that they can have meaning – and otehr times that they are useless.

        I don’t have time or energy to address each of your concerns – but please do not put beliefs in my mouth.

        I do like your statement about recognition and celebration of accomplishment – and a bar for professional performance (which does not guarantee it, but is an indicator) without feeding the power un-equilibrium.

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    • I wonder whether you could be a bit more candid?

      When you say that getting a doctoral was a way out of poverty for you father, you expose quite clearly how it’s about money (same as psychiatry and pill pushing, and guilds and wallstreet); thank you.

      And then you’re disgusted that chiropractors would call themselves doctors because you “know that their degree was probably easier than” yours. I had such a problem with one side of my hip that I couldn’t bend over to tie my shoes properly, I went to a clinic (“med” clinic) and the “Doctor” there even quite glibly mentioned how the “insurance” wouldn’t pay to see a chiropractor, and actually mentioned how if the problem with my back and the pinched nerve didn’t go away, they would do surgery. And this was standard “procedure” for a “med” clinic at that time (twenty years ago or so). So, I went to a chiropractor, paid for it myself, and the problem went away within a week or so. The chiropractor even called the insurance (I had a pinched nerve that prevented me from moving properly, which would have lead to greatly inhibited ability to move were it not fixed, which he accomplished WITHOUT the trauma of surgery) but they wouldn’t pay for me to see him. Years went by, I had gone to see the chiropractor every month or every two months, but then stopped; and acquiring neck problems (and paying to see the chiropractor really wasn’t something I easily could afford as all) found out that the HMO I had had to change to in order to get therapy would pay for 18 chiropractic sessions a year. Within two years my life has change, although I had to find exercises on my own, change my diet, allow thoughts or emotions some legroom they hadn’t been encouraged to have before, learn how to meditate to calm myself; but the chiropractor helped beyond measure; when the “Doctor” would probably promote insulin shots. And I really don’t think that having to do research that’s not in the mainstream money market, to actually help people in a way that an “honorific” and it’s “privileges” would bypass, that that means that their degree was easier than yours. For one thing, I doubt that after accumulating a degree (wherever they put it), that they as easily believe that they have made it, because it was so much hard “work.”

      The arguments you make as to why the honorific should be honored (“working one’s way out of poverty”, “a medical stance that caused more work to get than others”) is exactly what psychiatrists would use to excuse why they continue needing the “lifestyle” and why they are the “authority”. I don’t know how this would be inappropriate for this site, other than the logic is inherent rather than in your face. Insurance companies often don’t pay for therapy going beyond such a grip on how the market works for those with such privilege, and people who truly need help consequently don’t have funding for what would help, ending with what doesn’t (might suppress a symptom temporarily causing more problems in the long run which calls for more “treatment” and more money feeding the “honorific”), further perpetuating the divide between poverty and those that have more privilege. And to pull your way out of poverty becomes being assimilated into getting an honorific, and promoting what doesn’t help; while those who are stuck needing something else but sticking to what truly helps means poverty, disenfranchisement, total confusion as to what the bleep is going on, having to find answers way beyond the “hard work” of those with an “honorific,” and not having it acknowledged when those answers are found; but heh oh: I” am Doctor so-and-so and pulled my way out of “poverty”!? “

      You can gripe about chiropractors and functional doctors, but that is where the trend is going as to who really can help. That’s for people to decide, not those who feel they have “worked” so hard, and pulled themselves out of “poverty” and consequently feel they deserve an “honorific.”

      For ANYONE to say an honorific is something they deserve because of fill-in-the-blank work they have done, when others don’t see it that way or their ability to function is complicated by it, is quite abusive. Honor is something that comes from people who honor you, not from a title given by an institution that enforces it.

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      • Chiropractors – you were helped by one; I was harmed by one. What can I say?

        So – how do we determine what honorifics are “okay” and which ones are not?

        My father was about more than money. It was about his taking charge of his life and working hard. He earned it, and the respect that went with it. To reduce it to merely “poverty vs. riches” is to remove all nuance from that story.

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        • Psychiatrists and doctors- You were helped by one; millions had their lives ruined by them. What can I say? Besides that I at least haven proof they have ruined millions of lives.

          How about we determination what is okay based on using logic? Appeals to authority are a logical fallacy.

          The Chiropractor was about more than money. It was about taking charge of their life and working hard. He earned the right to use logical fallacies. To pretend this is about working hard is to lie. This is about a systemic use of poor logic that causes oppression and death.

          What is happening is that you want different standards for different people. Stop pretending wanting certain people to have more rights and status isn’t about a desire for power.

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      • JanCarol, Sara has already stated that this argument is about whether honorifics use is appropriate in general not about whether anyone has truly worked hard to reach that level when it is in practice, but that should show in their work, not a title enforced by an institution. And her asking whether there’s a better way doesn’t mean she’s putting beliefs in your mouth.

        That an honorific denotes respect is questionable, certainly in this day and age, which it is currently, when so much including education is controlled by corporate interests. Colleges in the USA became fronts for investment institutions in the early 80’s: not exactly investment institutions but fronts for them.

        I stated how it works regarding the economy, and how the whole process of who gets “respect” can be in collusion with poverty. Something that deserves being noted in this blog where the emotional symptoms of poverty can be diagnosed as a psychiatric disease, to cover all of that up. That also becomes more than simply taking charge of one’s life and working hard, and having a piece of paper giving one “respect” beyond those who are seen to have personality flaws that they don’t or/nor can’t. And what I wrote wasn’t at all ‘merely “poverty vs. riches”’ it was a clear explanation of how an honorific can be in collusion with creating poverty. In fact to bypass all of what I said in order to make claims that I was lacking nuance truly on your part is a lack of nuance.

        “We called him Doctor; he earned this. It was more than a piece of paper, it was his growing identity. Something which made him stand out from the pack – his family, his friends, he achieved all of this on his own.”

        You also state that

        “He remembers standing in line to get shoes, ashamed that he had to beg for them. ”

        That’s a lot of concern for “identity” and whether one has enough money or a piece of paper. And a society that engenders shame depending on whether you have to stand in line to get shoes really has extreme problems with what pride would be would it be there instead of “shame.”

        It sounds like your father really had it hard, as did everyone during the depression, but you don’t mention how he helped others, you mention he stood out from the pack, that doesn’t say he was respected for his work but that because of the honorific he stood out from them. And what about the pack he stood out from, and their poverty? Someone to me would stand out from the pack when they have done something that earns respect from them, rather than a piece of paper enforced by an institution. Neither are business institutions often those that help others in poverty, although again someone that worked their way up in such is made out to deserve respect.

        If your father truly helped others, and acquired respect anyone would have without being in a field where an honorific is doled out including when they are, everyone would be glad to hear that. But to get offended and display resentments hitting on straw-man arguments as if having a viewpoint about honorifics is an insult to your father, this is not what Sara stated. I wonder how much can’t be said or it’s seen as an insult or getting in the way of respect. Working hard for a degree and getting an honorific is working hard for a degree and getting an honorific, that says nothing about what a person has done for their community or for others, or what kind of respect they engendered simply by their actions themselves, not whether they have an honorific, and how much work that’s seen to have entailed. A person who has completely been disenfranchised by society can work quite a bit harder just to still see beauty in the simplest things, and not lose it.

        YOU are the one that said you were disgusted because you thought chiropractors didn’t work as hard as you did for their degree, again hitting on the idea of working hard, as if that only occurs at an academic level and what kind of a degree you get. To speak of taking nuances out of a discussion. Nuances also aren’t dressing up personal resentments, and then accusing others of not being nuanced when they delineate there’s more to the argument beyond your “nuance.” You don’t know how hard chiropractors work to be up on stuff what the medical profession might dismiss, regarding alternative health, and there are all sorts of avenues they support that go beyond what one would get steered towards, or even would be allowed to be steered towards from a “Doctor” of medicine. That takes a lot of work beyond what’s simply put forth from a curriculum from an institution doling out said honorifics or not, recently quite controlled by corporate interests as a front for an investment institution. That again also effects where the money goes, and who has a decent or easy income or not. This doesn’t change whether one has a doctoral in business either. And you twice now have mentioned that someone who does get such rewards works harder. I don’t agree, and consequently I can only further question whether that’s taking charge of one’s life.

        And I don’t know what your problem with a chiropractor was, but I do know that the medical profession has been quite active in trying to legally suppress their practice, which despite considerable action hasn’t worked, because chiropractors DO help people, whether you’re disgusted as to what you interpret as hard work or not. I also mentioned the problems there used to be with insurance, and with some HMOs still are in place, although chiropractors CAN help people and in my case to avoid completely unnecessary surgery and other damage and trauma to the body. That that isn’t seen as medical, or respected, or that the “medical” profession would try to prevent people from having a free choice regarding insurance, or acknowledged status is truly oppressive. That’s way beyond: A chiropractor helped you but they didn’t help me, so what can I say? I don’t know what your problem was with a chiropractor, but I think a lot of people don’t like having gone to a chiropractor because when the discs are adjusted to be more aligned, this brings up problems in behavior or posture and muscles that have gotten used to being used in-properly or out of balance points this out with pain trying to encourage them to change their habits, which they don’t, and then they have a problem. The same with a nutritionist, people don’t like changing to a healthier diet when when they have become accustomed to an unhealthy one; but then again the medical profession often isn’t even privy let alone articulate regarding such sensitivities.

        There are MANY people on this site who have SEVERE problems with their medical doctor or psychiatrist, both with honorifics. Chiropractors you say disgust you when they call themselves a doctor, which they are allowed to do but not call themselves medical doctors (although recently they have to do a lot more medical training to get their degree), but it’s fine to be a doctor of whatever else when it’s not seen as medical. Business for example.

        And what about the people on this site who may simply for emotional reasons need to hear that said honorific doesn’t mean what it’s made out to be, people who have been truly tortured by their psychiatrist, and they can’t even say that it didn’t help them without being seen as non compliant!?

        And that ISN’T just a topic to be dismissed as inappropriate because of “linguistics.”

        I also find that your comments are riddled with mirrored statements. You dismiss the nuances or counterpoint of a statement and then say there’s no nuance to the discussion, because your points were challenged, that regarding the collusion with honorifics and business for example. And when Sara simply asks a question you can answer regarding the potential of whether there’s another way to gender respect than an honorific, you act as if she was putting beliefs on your mouth. I see that more as how you misinterpreted what she truly stated, and thus put beliefs on her.

        Initially reading your response I thought, yeah, of course an honorific can mean something to a hard working person, and then they have some respect in their lives to get through the day, and have some pride; but when you dismiss nuance saying it’s lacking because people share valid counterpoint regarding the content of your post, and then the straw man arguments, I truly have lost that although I can still see it in others who might want a honorific…

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  12. I am not even sure what the doctor title suggests.
    It used to be that a doctor was a person that tried to give aid to people.
    I know that the word doctor also entitles one to harming people. Legally. In court a doctor title tells everyone that he will not lie, nor misrepresent, nor invent, nor harm and that he ALONE, hold the ultimate truth and objective view of the mind and body. And in the case of theology, that he alone knows god.

    I honestly don’t know how I feel about this. People are paid off for not just their sheer hard work, but the ability to do so. The ability to do so, plus your “will”, desire or whatever components it takes to get a degree, you are rewarded by a title.
    Is that ability to be smart enough, retain information, driven, is that a credit to who we are, did we invent the basics to get there? What about those that are less capable and can never get beyond being a toilet cleaner?
    I have no clue what it feels like to succeed. “success” as is honored in our society.

    My problem with the word doctor is that it really misrepresents what is actually known. A doctor of neurology knows very little and sends most of his clients to a doctor of psychiatry. Perhaps we should address them as “doctor of psychiatry Smith”, and “doctor of medicine Jones”. (and in NO way am I undermining the amount of crap the neurologist has to learn and memorize, study and pass tests) But does he diagnose or treat? Being a doc has become much more about diagnosing and overriding science with sham opinions and drugs. They are not the heroes we thought they were, because of the fake science. Or mainly the fact that “research” is presented as science, and much happens now by theory.

    I think in medicine, it is helpful to use the word Doc, just so the patients know who is who, although this does not mean honesty or quality lol. But really, if you introduce me to a doctor, I have no clue if he can fix a liver or if he can get my mind all better or get me into heaven.

    I do not see it as an “honorific”. I use it strictly in the sense of what you do. I do not address my daughter as “engineer Smith”.
    Nor do I say “My daughter, the engineer”. But wholly geez, there are indeed many mommys that say “my son the policeman” in which case I fall all over them because I am beyond impressed.

    But yes I hear you on “falling over themselves”, which is comical or a turn off, not at all born out of sour grapes, and I wish they could see this. But then I don’t give a shit about someone’s huge house they worked for. I don’t care that you own a yacht. But those accumulations were also born out of hard work or BS or luck.

    I wish that the doctor title was a guarantee of honesty, humility and dedication. But all it really tells me that their brain works in ways mine never could. But I have seen enough doctors where I had to search all over the dam internet to try to come to understanding and yet to carefully suggest the new information is like walking on hot coals, especially if approaching a new “specialist”.

    It is imperative that kids go on to receive an education to become “something”. There are only so many openings to become someone with an honorific. The rest of them get to say the honorific.

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    • Actually, I know a few people who were saved from doctors of psychiatry by doctors of neurology – stating that they were damaged by the drugs. . .

      It is something to consider when the drugs and “treatments” have so severely disabled you, that a doctor of neurology might be the path ***out*** of psychiatry.

      If we didn’t have to taper, we would need no doctor at all, but in today’s legal climate, buying black market drugs is a bad idea for your tapering. You need a prescriber.

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      • And ideally since neurology put the word out that getting hit on the head with a hammer can cause brain damage, it would be responsible medical information to warn people in regards to psych drugs. Not to tell people after the fact. “yes you were damaged by the drugs but I have no clue how to fix it”

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  13. I don’t have a problem with medical doctors insisting on calling themselves or being addressed by others as Dr.

    I do have a problem with non-medical doctorate-holders insisting on being a Dr, especially in the health fields, as I consider that to be a cynical attempt at deception, rightly or wrongly, it’s how it comes across to me.

    Dr Who is a non-doctor but is also non-human and non-actual so I can forgive them for the adoption of the prefix.

    Dr Seuss too, likewise.

    But the Dr title is so often used by people selling snake oil, by New Agers scraping the bottom of the barrel of legitimacy that restrictions on use should be imposed.

    As for feeling a power imbalance with a Dr in the room. Well, that’s likely because there is one. They do have more power. They’ve been entrusted with it. Same as the classroom. There is usually at least one person in a classroom entrusted with more power. Same in a Presidency. A boardroom. A prison. The military. There are echelons, almost always for good reason.

    Doctorates can be purchased online for little money from enterprising New Age colleges. Get one of them and call yourself a doctor. That will wash away naming convention anxieties. The power balance won’t be affected.

    “O… I didn’t realise you were a doctor.”
    “Yes, Dr. I am a Dr. Just like you.”
    “Doctor of what?”
    “That’s irrelevant. I’m a Dr, just like you. I’m equally powerful.”
    “Doctor of what?”
    “Never you mind.”
    “I’d like to know. I’m a doctor of medicine and you?”
    “I’m a Dr of Ancient Quantum UFO Ching.”

    Yeah right…

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    • rasselas.redux,

      Thanks for your post. And yes, there is a power imbalance. However, in many regards, it is a misplaced one. As I noted in the piece above, the medical doctors (and frankly, doctors of other types as well) often spend the least time with someone, and yet have the most power over them.

      I am curious if you’ve seen Daniel Mackler’s Open Dialogue film? In it, one of the things they emphasize is how the medical doctors do NOT function with such a power imbalance over others on the team. I’m actually uncertain whether or not they are referred to as Dr. Last-name while everyone else is referred to by their first name… But I’m going to find out.

      My point in bringing it up, though, is that the power imbalance needn’t be so great, and we needn’t be complicit in it. I do hear you on the added confusion of so many people getting to call themselves Dr. Last-name above and beyond medical doctors… But I think it’s an issue across the board.



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      • Agree with this Jan, but then, psychiatry should never have called themselves “doctor”. It is their title that allows them to tell the story. It is their title that courts listen to, not the story. The identical story could be told by myself, about another human in court, but it would not hold the absolute unargued truth as does when coming from a “doctor”. And the story of the patient has no meaning at all.

        If we are trying to defend a mental criminal in court (one must be a criminal for being brought to hearings) we have to beg Peter Breggin to defend our honor or damage, because even if I brought in 50 people who tell the court my story, it has no meaning. Just words without the doctor title.

        So yes, it means they worked hard to get that title. And it earns them a certain kind of respect, but the very title can also be the biggest weapon they have. In the case of psychiatry, it is a dangerous weapon, because the information from those years of earning the rights to spout garbage and chemical prescriptions, is false.

        And there are a heck of a lot of “specialists” Doctors that participate in the spun stories.
        Perhaps we can educate the public on what the true meaning of doctor is. That it is a title bestowed because you literally went to school for 8 years. Because you were gifted with the wherewithal to somehow remember what you read, to be able to express it, to expound on it, to regurgitate information, and sheer work of study. And we also know that some have to study much harder and work at the same time. But the majority of doctors do not have the burden of debt.
        But what IS the study? And what kind of person are you walking around with that title? Are you worthy of people falling all over themselves, over you? (although I think that really is not happening anymore, at least not by the people that go to doctors lol)
        A doctor should provide no more actual information than he has. And the crap learned is someone’s information, but it is NEVER the information of the people he will serve.

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      • Yes, that’s true JanCarol, but there is this issue in the news about the future first lady, and I don’t know..

        Maybe there’s more click bait mentioning her, and someone who might be steered the wrong direction from the “medical” authorities would stumble on this site, and it might save them from years of having to deal with a disabled mind from “treatment,” instead finding something that does help.

        I’m trying to think of a funny example how the title of a book is important. But I sort of fail. The Scarlet Letter for example. If that was called “Historical Concepts of Sin,” that rather falls short. Or. “The Minister that Didn’t Know Where to Put it,” also….. Or worse than that, since we’re talking about honorofics, which “Minister” is one of. “Minister Dimmsdale and his word-that-also-starts with-D-but-might-cause-trouble-being-mentioned,” and if you want to be less colliquial there are also the letters P or L. Neither of which the Minister had to have embroidered on his robes.

        And Why honorifics start with D (doctor) P (professor or priest) or M (man…oops I mean minister)!?

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    • From a medical profession prescribing drugs that are manufactured by businesses that function many ways just like a drug cartel, to medications that cause what they are said to heal (a chemical imbalance that causes the symptoms of psychiatric diseases) to an FDA that suppresses much of what can’t be copyrighted for profit, and you’re talking about snake oil as being fraudulent. I think in many cases snake oil is more healthy.

      And it’s the same “Doctors” that would and still do deny the healing Jesus, and other healers accomplish, Charlie Goldsmith to name one currently active you can investigate, and see how many people he’s helped, and his TV show. That you disbelieve that is your business, but to start making swipes at New Age, and pumping up said “profession” really …..

      The ones pushing their doctorate really aren’t the ones you mention, in fact they aren’t even interested in it. Doesn’t even apply to them. And to mention: “Ancient Quantum UFO Ching” as if that disqualifies everything the same way a psychiatrist would talk about hearing voices, seeing things that aren’t there, having emotional problems when such stuff isn’t given legroom to express itself etc. etc. etc….

      The Chi energy from acupuncture you can’t dismiss anymore, and then there’s their herbal knowledge, the amount of evidence there is that there was an ancient culture that shared technology and built structures that with our present technology would be extremely difficult or impossible, and could have come from aliens this can’t just be ignored; and simple things like the wave-particle duality and how observation effects matter, that shows we aren’t separate from the things we observe, and thus those around us if nothing else points out how emotions effect our lives…..

      And further more, those really aren’t the people calling themselves doctors, or even demanding to have such honorifics, they simply do what comes natural to them, share it with others, and it helps.

      I’ve have stuff healed from such people. I had prostatitis that a man, now deceased, helped heal. Because he showed me “somehow” there’s a place where everything I would think is unforgivable of myself can be washed away. Interestingly the body I saw in that place was from a past lifetime. Regardless of all of that what the medical profession doesn’t really have an answer for went away. And this man mind you, as a child had such healing take place, but this scared the Catholic Church thinking it was a sign of the devil, and he was put in an asylum, giving shock therapy for a year and then forgot all about it till years later his life fell apart, supposedly, and he went back to being himself rather than a piece in society’s machines. And yes, he was deemed as having been given special gifts by the devil, and that shock treatment wouldn’t be uncomfortable to the devil who would loosen his grip on the boy. You can hear his story here, starting 11.53 into the video
      And then there’s who recently helped me get closer to (yes Jesus) and shed the infection in a tooth that wasn’t supposed to go away, and I was told multiple time to get a root canal for instead (I wouldn’t have done that either, I’d have had it pulled, see documentary Rootcause and other very articulate scientific exposés that the dental industry suppressed and from being known because root canals are their biggest bread winner or who knows why, like the drug companies and psychiatric drugs) Carol then doesn’t say she heals anything, she brings down the higher energies.

      That’s two definite healings that the medical profession couldn’t have accomplished for me, and further more I’m truly simply interested in healing that’s spiritual and then beyond that healing regarding “symptoms” of a psychiatric diagnosis I shouldn’t have to go on more about that here. And I could go on for pages about metaphysical or “impossible” things happening when I was “psychotic.”

      And then there’s Charlie Goldsmith who simply pointed out that feelings are meant to be felt, and when i realized I was pushing them away because they hadn’t been accepted, I got away from reflexes like drinking too much coffee that, although they expressed that I wasn’t allowed to express my feelings, didn’t give them direct leeway for legroom. Carol’s healing method where she asks people to sit quietly for 20 minutes twice a day also helped for me to see what my reflexes had become, what I could let go of, from little scenarios of dreams I could interpret.

      And then there’s many more


      there’s Dean Kraft

      There’s Michael Stellitano

      There’s many more

      And what’s interesting about your sarcastic post is that many “New Age” people think they have such abilities when they don’t, or that they know better, as do many “Christians” deciding such things aren’t from God (who knows why, indoctrination, no honorific from the church, same as the pharisees, same as what happened to Gene Egidio)…

      But there’s simply is a difference between healing that happened, and those condoned with an honorific. To make snide remarks about people who are needing no honorific, never having asked for one, and simply are healing, but then to be made out to who knows what because they heal and want to help people, and can, and should be allowed to without hindrance, and that means those that have been told they can rather than accomplishing such feats have to show a little curiosity or some humility some reality based thinking rather than indoctrinated programming as their identity, their excuse…..

      And you can go on an on, maybe you need to, but you’re not going to convince me.

      And at least on this site I can share my viewpoints, my experiences, share links for those interested, and not be dismissed because I don’t have whatever title, or who knows what….

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  14. I have indeed seen Daniel Mackler’s Open Dialogue film and I have read reams of Open Dialogue texts and I can proclaim with utter sincerity that I still don’t have a clue what it is.

    I have attempted discussion numerous times with Open Dialogue excitables online to ascertain what it is and have never succeeded in ascertaining what it is.

    And two years ago I had the opportunity to speak one to one with someone not only trained but also working in an Open Dialogue system and they were not only unwilling to explain what it is but actually became so hostile I was readying my Jiu Jitsu in readyness, they were that wired.

    What I do know is that no two people speak the same things about it and all my anxieties about ripping up the legacy of Bakhtin were and remain legitimate.

    I think if you aspire to transparency and equality then a quicker and unimaginably more sincere route other than offering oneself over on first name terms would be to just hand out a resume which noted payscales and investment interests. Then take it from there,

    Might also be helpful to be forthcoming about voting habits, political allegiance and private member groups.

    I’d like an Open Dialogue for example in which people were transparent about Freemason membership and any affiliation whatsover with secret services.

    Of course that’s where supposed openness breaks down and it’s pretty much game over exactly at the point you needed game on.

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    • I would also demand that all in attendance made available full and complete access to

      – all their bank records and credit files
      – their entire internet history
      – their complete school record
      – their complete record of all encounters with law enforcement, any fines and convictions etc
      – their entire phone call history and SMS history
      – a summary of all their significant relationships
      – a complete record of their passport history
      – a complete record of their ANPR data
      – their DNA profile
      – their complete medical history including psychiatric history if they have one

      Then we’d be equally open and good to go.

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    • rasselas,

      Eh, my point wasn’t so much how great Open Dialogue is, as it was that there are some fundamental differences in power imbalances there between Dr. and non-Dr that I think are interesting and worth exploring. I do talk about Open Dialogue a fair amount because it has good examples of a lot of principles and values… Such as seeing the problem as existing in the space *between* people even if its most visible in *one* person. I love that simply because it is about not automatically medicalizing every bit of distress and knowing that it is often a product of relationships and environments. There’s also the reality that people are available right away rather than after a wait, and that the structure of their system (which is the whole system and not just a hard-to-access alternative to the system in that particular part of Finland) engenders enough trust that many people reach out at the start of their struggles rather than trying everything to avoid it until things get worse and worse. There’s also the approach to psych drugs which leads to no automatic assumption that everyone needs to be on them at all, or that – if they do use them – that it can be just short-term (and short-term can be defined as as short as a few weeks rather than a year or two)… as well as the fact that sleep meds are among those most commonly prescribed because there is a fundamental understanding there about how much meeting basic needs (like sleep, etc.) can lead to distress in a way that is pretty absent here. There’s also the principle about having discussions *in front of someone* rather than in a back room behind their back, and that two clinicians take part in the support rather than just one to facilitate that process… And that – because its recognized that problems lie in the spaces ‘between people’ – the presence a family network (with ‘family’ defined by the person and including whoever they think makes sense including employers, neighbors, whoever) to work through things.

      In essence, it’s less a magical thing you ‘do’ to anyone, and more a process of building trust and recognizing that someone’s distress is often the product of what is going on outside of them rather than within. But I am not intensively trained… I’m mainly relaying what I’ve come to understand from other sources, and what I usually highlight when facilitating trainings myself because it represents so many fundamental shifts from how most places respond to people.

      AND I’m absolutely not someone who says ‘Open Dialogue’ is the answer to all… It has its downsides, too, and is nearly impossible to replicate in many other areas no matter how hard people try because the trust that has been built by constructing a system that holds these principles is a totally different experience than an alternative offering that represents a little pin drop within a system that runs counter to them (among other challenges around differences in liability issues and perceptions related to psych drug prescriptions and so on).

      But again, I really mainly brought it up because the massive power imbalance that exists between those called Dr. and those not isn’t true in every area, even where medical systems still exist (most of Open Dialogue is facilitated by nurses after all). And I think we’d do well to look at how to begin reducing those massive power differentials with the tools available to us as a sort of harm reduction approach. Looking at the honorific system is but one way, but I think it’s an important one because its free, and because training people every single day to call a certain set of people ‘Dr.’ absolutely and totally influences how automatically reverent they may be to them. I see this playing out all the time even where a Dr. is considered an employee of an organization that technically has more power (hire/fire, etc.) but still bends to the Dr. on a daily basis and without question even when what the Dr. is doing is blatantly abusive and/or misguided.


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      • Thanks for clarifying, Sera. You’ve given me a number of mental jolts in a good way. Just that it’s going to take a while to think through them.

        The in the meantime observation is this:

        You are very much it seems to me in alignment with the revolutionary ideas of Dr David Cooper and his attempts to strip away power at Villa 21.

        There are multiple accounts as always stertching the full spectrum of failure to success but for me the most telling aspect is that overall when people are in chronic or acute stress states one of the most humane things you can often do for them is to reduce the burden of decision-making.

        Which is perhaps why the patients at Villa 21 conspired to reinstate power differentials because the stress of their troubles was already enough to be dealing with.

        I agree with you that power differnetials are often best kept in the light and under review and discussion because these can often be the source of repeating pain and strife, especially but not only for those with histories of severe abuse.

        However stark power differentials are not automatically sources of abuse and something to be eradicated.

        In all groups there are orderings of leaders and followers, thinkers and doers, peacemakers and peacebreakers, loyalists and traitors and so on.

        I’m perhaps not the best to comment on groups because I don’t like being in them. I don’t mix well with others, am not much of a social being even if at times I can perform a pretty convincing mimicry of one.

        Happy Christmas.

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        • I think the problem is more one of designating certain people to be in power based on the number of hours they spent in the classroom or the amount of property they own or the kind of asses they have kissed. There is such a thing as legitimate authority, but it’s not based on a person’s degree.

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          • “There is such a thing as legitimate authority, but it’s not based on a person’s degree.”

            I see discussions are continuing to go around in circles.

            An authority in any hierachical institution is legitimate because they have been legitimised by the institution to be an authority, and authorised by the institution to command power.

            Walk into any institution and you can attempt to cause mayhem by pointing out the arbitrariness. And miss the whole point of an institution.

            This is the problem of reform. The lesson learned by Dr David Cooper.

            And why eventually Judi Chamberlin came along and wrote On Our Own.

            If we do not know history and learn from it we are doomed to repeat the mistakes of the past.

            If you want a libertarian non-hierachical grouping of mad people and non-mad people then your best bet I believe is to set up some custom Sims world and let it run.

            After a very short amount of time you will end up with a very wooden and strange-looking simulation because in the absence of hierarchy humans can’t be human (and simulacrums can’t be simulacrums).

            The whole pretence of a non-hierarchical or equal social group is pure libertarian or anarchic fantasy. Some people are more capable than others. Some people are more socially skilled or socially cunning than others and that fact alone creates tensions that lead to power imbalances.

            The healthiest hierarchy is one which is regulated independently, where the fight against corruption, nepotism, cronyism and so on is ongoing, where power is accountable, and where values aren’t simply statements but actual cultural norms.

            What Sera and yourself seem to be suggesting is that mental health institutions must restructure themselves in such a way that a small minority of people-with-a-personal-experience should be given more or at least equal power and this would make the institution more legitimate and the rationing of authority more credible.

            Such that for instance if someone wished to take on a powerful position in a mental health institution they would progress their career by having a severe mental breakdown?

            And that no-one should be in a powerful position in mental health purely on the basis of achieving a respected position in society through hard study and training?

            And this would make everything more valid and legitimate?

            “I don’t like to be the least powerful person in the room,” says the person in the room that allows a tiny minority into the room and excludes the vast majority of others…

            There are people who are asked to comde forward over and over, the same faces over and over, and they do not represent myself or anyone I know, they represent themselves and their personal agenda.

            Drs for instance are expected to be trying for neutrality and reaching for objectivity. In psychiatry they are chosen to represent a cultural narrative which satisfies the state and the judicial system and the public.

            Not sure how someone-of-mental-illness-experience so to speak can be thought of as more legitimate when they will likely not satisfy the state and the judicial system and the public with a narrative appropriate to a Drs level of power.

            Not convinced the the state and the judicial system and the public would be comfortable with a shifting of institional mental health setting power to people who have attained that power by having severe mental difficulties. I do not see anyone being much convinced or persuaded or reassured even by such a shifting of power in our mental health settings.

            Which again Judi Chamberlin recognised decades ago, as did Dr David Cooper and others. Cooper hung up his hat on the matter, Chamberlin went full-on breakaway anarchic.

            And since then all independent models of mental healths settings have been collaborative with existing conventional hierarchical settings. And those that are argued as truly independent never worked, perished quite rapidly, descended into chaos.

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          • Actually, I don’t think you get what I’m saying. I’m not suggesting that “lived experience” per se automatically gives one natural authority. It is based on one’s competence in accomplishing the tasks at hand. And you’re right, hierarchy does seem to be a natural outgrowth of human groups. I’m saying that the optimum situation is where the official “authorities” conform as best they can to natural authorities, and that such authorities that do exist in the hierarchy respect the fact that their position does not preclude someone else knowing more than they do about a subject, and that the ostensible “subordinates” don’t assume that the authorities automatically know what they’re doing.

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        • “in the absence of hierarchy humans can’t be human”

          Oh really?

          Those with a “schizophrenic” diagnosis (I even wanted to say “definition” for some reason) actually do better when they haven’t been under mainstream treatment, in fact no treatment at all means they “recover” better. That’s then not human? Same goes for the whole psychiatric industry and its “heirarchy,” those free of it aren’t as much part of the epidemic.

          I really don’t think you’ve defined human, and you’re truly doing what the mental health system does, as well. You created this subgroup and given it hegemony. And decided people not going along with it are non reality based, same as such phrases as those that don’t go with statistical based norms, or consensual reality deportment. Next you need an enemy to make out those not honoring honorifics are putting the group in danger. And thus being human is being separate from all that is human or everyone that is, which hardly could be human.

          You stated:

          “I see discussions are continuing to go around in circles.”

          And then you display exactly what goes around in circles.

          “An authority in any hierachical institution is legitimate because they have been legitimised by the institution to be an authority, and authorised by the institution to command power.

          That’s exactly what doesn’t make something legitimate. That makes it condoned by the institution, but that doesn’t make it legitimate.

          And then you say:

          “Walk into any institution and you can attempt to cause mayhem by pointing out the arbitrariness. And miss the whole point of an institution.”

          So the point is that an institution condones authorities which aren’t legitimate, but then they are legitimate, and this is the point of institutions (at least people think there’s a legitimate authority but that doesn’t have to be legitimate for it to be legitimate)…

          So basically if an authority actually is based on truth it won’t work in an institution….

          Yeah, goes along real well with sacrificing goats, virgins, wars against a fabricated enemy to make people think they are in danger and wage mind control, and psychiatric drugs.

          Because: “in the absence of hierarchy humans can’t be human”

          And thus you’ve also fabricated an idea of hierarchy that doesn’t create a structure. Or that truth only exists if it’s agreed upon, because then it’s institutionally involved then.

          And I’m not at all saying that with brainwashed people, when you can’t get them to question their beliefs, their consensual reality deportment, their whatever’s going on that pretends to be the answer, the title, the definition of who’s who in their nice tight little web of community holding together their closely knit gang; that you can’t just go along and call whoever Doctor, or Priest or Guru or President or Emperor, or First Lady and then maybe make some change and introduce some ideas that from their softness create light that would spread.

          Because it’s NOT about “Doctor” or whatever honorific, so it makes no difference to use it or not, which shouldn’t be why you have to use it either. And neither does using it mean you’re not free to not use it or even not really believe in it when you use it, other than it’s not what it’s made out to be anyhow, so it doesn’t matter.

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          • Sam: Well. That’s not completely – although I appreciate your appreciation – the truth about: ”those free of it aren’t as much part of the epidemic” because with Peter Pan logic, it’s really those that are free of it that are the most part of the epidemic, because they are the most capable and able healers. Regarding he-who-shall-not be named and you-know-who. But then there’s He-who-has-no-childhood as well, you see? Those that are so humped up they really don’t attach any significance to who they are responding to.

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      • Sera:
        Do you have a problem with power imbalances? To confront the injustice? The concerns being addressed seemingly are focused on the quantity rather the qualities by which power, empowerment can be realized as a challenge to be understood? Or released through empowering work relationships. Being this is work (which may need to be rexamined conceptually), when do the scales move or do they in a balanced imaginary world (if there is a way to recongize a shift in understanding/learning that will afford common ground)?

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  15. Hi Sera, thanks for the blog.

    I am not even sure what the doctor title suggests.
    It used to be that a doctor was a person that tried to give aid to people.
    I know that the word doctor also entitles one to harming people. Legally. In court a doctor title tells everyone that he will not lie, nor misrepresent, nor invent, nor harm and that he ALONE, hold the ultimate truth and objective view of the mind and body. And in the case of theology, that he alone knows god.
    I honestly don’t know how I feel about this. People are paid off for not just their sheer hard work, but the ability to do so. The ability to do so, plus your “will”, desire or whatever components it takes to get a degree, you are rewarded by a title.
    Is that ability to be smart enough, retain information, driven, is that a credit to who we are, did we invent the basics to get there? What about those that are less capable and can never get beyond being a toilet cleaner?
    I have no clue what it feels like to succeed. “success” as is honored in our society.
    My problem with the word doctor is that it really misrepresents what is actually known. A doctor of neurology knows very little and sends most of his clients to a doctor of psychiatry. Perhaps we should address them as “doctor of psychiatry Smith”, and “doctor of medicine Jones”. (and in NO way am I undermining the amount of crap the neurologist has to learn and memorize, study and pass tests) But does he diagnose or treat? Being a doc has become much more about diagnosing and overriding science with sham opinions and drugs. They are not the heroes we thought they were, because of the fake science. Or mainly the fact that “research” is presented as science, and much happens now by theory.
    I think in medicine, it is helpful to use the word Doc, just so the patients know who is who, although this does not mean honesty or quality lol. But really, if you introduce me to a doctor, I have no clue if he can fix a liver or if he can get my mind all better or get me into heaven.
    I do not see it as an “honorific”. I use it strictly in the sense of what you do. I do not address my daughter as “engineer Smith”.
    Nor do I say “My daughter, the engineer”. But wholly geez, there are indeed many mommys that say “my son the policeman” in which case I fall all over them because I am beyond impressed.
    But yes I hear you on “falling over themselves”, which is comical or a turn off, not at all born out of sour grapes, and I wish they could see this. But then I don’t give a shit about someone’s huge house they worked for. I don’t care that you own a yacht. But those accumulations were also born out of hard work or BS or luck.
    I wish that the doctor title was a guarantee of honesty, humility and dedication. But all it really tells me that their brain works in ways mine never could. But I have seen enough doctors where I had to search all over the dam internet to try to come to understanding and yet to carefully suggest the new information is like walking on hot coals, especially if approaching a new “specialist”.
    It is imperative that kids go on to receive an education to become “something”. There are only so many openings to become someone with an honorific. The rest of them get to say the honorific.

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  16. In Australia, the profession of Counsellor is not recognised in the way that Psychologist, or Social Worker is. I spent many years studying the impact of childhood trauma on mental and physical health. I find it fascinating and the research in the area is just exploding, turning psychiatry on its head. I finally achieved a professional doctorate from a recognised university here in Adelaide. I feel very privileged to have had the opportunity and capacity to study easily. The label means very little to me – unless I am trying to get a response for a client. It makes me angry that I get professional respect when I use the Dr label and on the other hand, often hear “only a counsellor.”

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    • My psychologist was a PhD psychologist. But I loved her, and called her by her first name. We were partners in my healing, so much so that I send her letters from time to time to let her know what I am doing in the world.

      I didn’t call her “Dr. Firstname” I called her Firstname.

      I guess what I’m saying is that I tend to take it on a case by case basis.

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      • Isn’t that grand Jan? I think most often we simply refer to the person with how we are introduced. Or once we get to know each other on a regular basis, we drop the “formality”…I respect Dr Timimi, but I refer to him as Sami. No clue why, I’m not being “disrespectful”. Perhaps because he is not referring to himself as “Dr.”
        I think often it might feel phony, or like I’m trying to kiss up to someone by using their Title. There are definitely times I use it, if I am in a hospital setting, if I ask for John, they might have no clue who I mean.
        Of course they might get pissed off at me too and accidently give me the wrong drugs 🙂

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  17. I think Steve that in the human world, we are supposed to be above abuse and shit BS, especially after receiving such an honorific. But seriously, I thought intelligence was about more than study habits, regurgitation and passing grades.
    I feel it’s pretty lazy to get your doctorate and not explore the mysterious world around. I mean even if a little scientifically minded, curious, about “health”, eventually your thinking could not make sense of the BS. And indeed there have been many that changed course because they could not bring themselves simply to satisfy the state.
    Sure it’s a job, but in the real world, it’s a state ordered damaged goods controller. Nothing closely related to health and certainly not healthy society.
    And of course it’s all we got but it’s not even serving society well.

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  18. Thanks for this article, Sera! I hear you, loud and clear. It’s a bit funny to me that this essay, out of all the things we could argue about, would garner so much resistance and pushback. But I guess it is to be expected from a society built on individual exceptionalism, and it’s economic system capitalism, rather than mutuality, collective wellness, and respect. I just wanted to say I HEAR YOU! And I think it’s a very valid point – that we recognize the accomplishments of some people with honorifics and salaries that go beyond what any single person actually needs, while sidelining, belittling, and ignoring the accomplishments of others who worked just as hard in other ways, AND how this leads to the dangerous situation of letting someone’s authority hold more weight than another’s – especially related to psychiatry. I work as a peer support person, and when a person’s prescriber tries to negate their experience by telling them that what they are experiencing could not be an effect of the medication, I like to say to the prescriber, “So when you were taking this medication, what did you experience?” And they can’t answer because they haven’t ever taken it. They have no direct experience. Point being, don’t dismiss someone’s direct experience of something. Listen. Try to understand. Take it in. Don’t immediately start to convince them that they’re wrong because “you’re the doctor/expert/authority.”

    Anyway, thank you again for this thoughtful piece! I appreciated the complexity you brought to it and how you amplify the larger issues at stake even in something that seems small, like calling someone Dr.

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  19. Steve McCrea wrote: “Actually, I don’t think you get what I’m saying. I’m not suggesting that “lived experience” per se automatically gives one natural authority.”

    Many of these problems raised by Sera yourself myself Dr David Cooper and Judi Chamberlin and many of the articles on Mad in America will be resolved by a human rights-based structured and implemented mental health institution.

    The kind of restructuring that someone like Dr Dainius Pūras is working towards.

    For example the appeals process is an existing process within the institution in which decisions can be reviewed. That process is currently weakened by the absence of a human rights focused approach. And will inevitably be strengthened by one.

    Particularly as the institution will be vulnerable to new ways of litigation. Although finding a balance poses a potential nightmare as it is possible that the institution could become crippled by human rights challenges…

    Happy Christmas.

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  20. The pharmaceutical cartel creates addictive toxic chemical and biological concoctions and other modalities , that for the most part endanger and take away the lives of human beings . And then they follow up with even more of the same type of toxic crap. This includes FDA approved electric shock boxes and anything else the pharmaceutical cartel wants to use on the people . The person subjected to even some of this is in a fight for their own life .Those that distribute the toxic poisons for the pharmaceutical cartel are rigorously brainwashed, given the title Doctor rewarded with cash payments and expected to produce according to guild requirements .They most all have a sophisticated song and dance , and work and cooperate together in one giant circle jerk . The pharma cartel, the AMA the APA the ADA (dental assn.) all their underlings along with the police, insurance companies, news media, FDA ,government, including courts. It’s really FUBAR . But then again sometimes you have to speak politely to these titled Authorita in order to get away from them ,even if only temporarily . It’s difficult not to fall into their clutches .

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  21. For someone to have authority over us, we must give it to that individual. Sometimes, we must give someone a “lip-service response” and pretend to that person they have authority over us. This is really to allow us to “hide in plain sight” and conduct our lives in peace, so that we can accomplish what we are meant to accomplish. After the experiences I have had in my life, for me to give the person authority, they need to earn it. This is as to my discernment and assessment. We forget that. A person may have all kinds of letters beside his or her name or all kinds of titles; but, if we do not give that person authority, that person has none. it is that simple. Thank you.

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  22. Human Beings are social animals like monkeys and there will always be a social hierarchy and being the sophisticated creatures that we are, there will always be the haves and have nots. I had my first delusional attack at the age of 17 but did not encounter a psychiatrist until i was 24 years old, in fact I kept away from all doctors until then. I spent 7 years free of medication but suffering delusions, paranoia and psychosis. My mental health didn’t improve and i am in fact lucky to be alive. The only thing that wasn’t affected was my position of work thanks to my parents support financially.

    It is time here in the UK for the New Years Honours List whereby the Queen gives out her Knighthoods etc. You could say our class system is quite embedded in our society and i unfortunately find i am at the bottom rung of that system. However, one of my current nurses informs me that he knows of a psychiatrist diagnosed with bi-polar who works within the NHS and this is quite an oxymoron in my opinion. Also another one of his clients (someone mentally ill) lectures on mental health. It seems that peer review is considered acceptable for employment in the mental health work place and that the more lived experience you have the better, but i wonder if the psychiatrist diagnosed bi-polar suffered from psychosis? Psychotics very rarely get accepted anywhere in the work place whether they have the title ‘Dr’ or not.

    The staff at Soteria House qualified as members by their lived experience and i think that still goes today. I have seen some remarkable work done by nurses including nursing assistants within the NHS working head on with patients and the system here is based on what actually is reported back to doctors by nursing staff then the doctor decides on what action should be taken as regards someone in distress.

    It’s an individual authority though, because those doing their job right whether they carry a ‘Sir’ before their name or a ‘Dr’ can use that title at their discretion, and it still takes many lived years of experience to be good in psychiatry and to give your patient the best care you can. Here in the UK there are no longer back handers to doctors received from drug companies to promote their drugs and such tit bits are not for the taking anymore by doctors as far as i am to understand and they are paid by set salaries. Insurance companies are rarely involved here with people except in negligence cases.

    The point I am making here is should we abolish the Queens Honours List here in the UK and never have people recognized for their good deeds and it has been known for small people like street sweepers to actually receive an honour, rarely but known to have happened, or should people never have titles?

    In the hierarchy of our societies I know I like having the title of Mrs rather than Miss because at 69 if i had a title of Miss then that would most definitely class me as a spinster even today because the title Mrs has a higher kudos.

    In the chocolate box of life I think that wrapping up people with titles can be a good thing but when it boils down to it it depends on how the person uses that title. There are good and bad doctors and there are good and bad psychiatrists. I would not for instance take away ‘Dr’ Peter Breggin’s title as he in my opinion has earned every aspect to being a doctor. In the chocolate box of life Dr Peter must be the exquisite French Truffle a very rare thing and i think he deserves the title ‘Dr’ in every capacity and description of that word. Besides the word ‘doctor’ comes from the Latin word ‘docore’ To Teach and i think basically there is without any doubt in my mind Dr Peter is the worlds most eminent teacher in psychiatry. To address him in any other way would make a mockery of all what he has taught us. So i am for titles and yes pro the use of ‘Dr’ before a name.

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    • Bippy, I doubt that being a nice or good doctor should entitle one anymore so to being addressed as Dr. Of course they should be awarded their university passing marks. PHD.
      It does not mean they should have to be addressed as such by every person. People get engineering degrees. We don’t address them as Eng. Smith.
      Or Foodserver Kathy.

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