The Corruption of Character in Medicine

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From the Journal of Bioethical Inquiry: “At the age of twenty-six, I decided to make a clean break with the past. I finished medical school, moved from South Carolina to Scotland, and began to study philosophy. It didn’t take long to conclude that I wouldn’t go back to medicine. While my reasons for leaving medicine were complicated—the anti-intellectual attitudes, the authoritarianism, the thinly veiled hazing rituals—the most important one was this: I had come to believe that medical training was turning me into a terrible human being.

That claim may sound overblown. Truly terrible people generally don’t realize how terrible they are. When you change over time, you see those changes from the perspective of the person you have become, not the person you used to be. What you once saw as cruelty you now see as strength. What you once saw as arrogance you now see as self-confidence. What you once saw as corruption and exploitation you now see as Realpolitik, the hard choices and necessary compromises made for a greater good. Coming to see the world differently may involve some self-deception, of course. But self-deception isn’t hard if you have a community to reinforce it. If you are surrounded by terrible people, it doesn’t take long for terrible behaviour to feel like the natural state of affairs.

Yet it is still possible to have moments of insight. You glance sideways into a mirror and feel a jolt at how cold your face looks. What used to be a smile now looks more like a sneer. Maybe you catch yourself laughing at a cruel joke, or ridiculing a patient behind her back, or lying to cover up a mistake. A sense of entitlement and superiority is growing inside you, and you like the way it feels. It’s not that you admire the members of the community into which you are being initiated. If anything, you feel a vague contempt. Yet you desperately want their acceptance.

Anyone who has attended a high school reunion understands that people can change dramatically over time. It would be surprising if such changes did not result at least partly from what a person has chosen to do for a living. A working life spent as a police officer will immerse a person into a community whose moral norms, expectations, and pressures are far different from those of a first-grade teacher, a hedge fund manager, or an orthopaedic surgeon. So common is the idea that certain kinds of work can lead to moral degeneration that it has become a staple of crime and war films: the gradual dehumanization of Joker in Full Metal Jacket; the slow transformation of Breaking Bad’s Walter White from a high school chemistry teacher into the drug lord Heisenberg; the metamorphosis of The Godfather’s Michael Corleone from a straight arrow wearing military blues into a ruthless mafia boss who can order the execution of his own brother.

Every organization will present opportunities for corruption, according to Little, Lipworth, and Kerridge; no organization can claim full immunity. ‘There will always be latent opportunities to manipulate the internal and external relationships to one person’s or to a group’s advantage, to pervert governance to benefit the institution unfairly, to deviate assets away from the proclaimed function of the institution, or to abuse public trust or institutional opportunities or powers,’ they write. Whether you exploit, tolerate, or resist those opportunities depends on the kind of person you are and the habitus you bring to the organization. They write, ‘(O)rganizations are “corruptogenic” for people of the right habitus’ (Little et al. 2018, 528.)

No doubt this is true. But it is also true that some organizations are far more susceptible to corruption than others. The opportunities for bribery and self-dealing are more varied and plentiful in the U.S. Congress and the average Wall Street investment bank than they are in a kindergarten or a public library. Nor is habitus—or to use the older concept I prefer, ‘character’—simply what a person brings to an organization. Organizations can also shape character. In fact, it is the promise of forming (or reforming) character that underlies the mission of many organizations. ‘The Marine Corps builds men’ said a military recruiting slogan that spanned three decades. A similar claim is sometimes made of boarding schools, football teams, and prisons.

Whether or not the working life of doctors corrupts their characters is an issue that Little, Lipworth, and Kerridge do not address directly. What they do acknowledge is that financial and technological changes have placed intense pressure not just on the way medicine is practiced but on the values doctors profess to hold. For those who, like me, worry that such forces can be steadily corrosive, the challenge is to identify the relevant moral pressure points. For that I will turn to the sociologist Richard Sennett and the cardiologist Sandeep Jauhar.”

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71 COMMENTS

  1. Even more disturbing is how most psychiatrists NEVER EVEN BEGIN to question what they’re doing or why they’re doing it, as they’re happy to follow the trail of pills Big Pharma leaves out for them, while other “mental health professionals” happily follow their DSM –

    • Nothing about the infiltration of bullying surprises me. Bullying infiltrated nunnaries and the priesthood and teaching and sports coaching and the movie industry and hairdressing and government and burger flippers and ballet and eco activism and atheism and and and and and…..

      So what can one do to remedy it. I feel the first thing to do is ban any person whose bullying is wrecking the lives of clients and colleagues. Bullying is not just in overt acts of pushiness or intimidaton but also in neglect, letting someone know they are unwelcome because of their difference. Bullying occurs because of a clamp down of feelings. Bullying is the numb absence of feeling looking for an excuse to outwardly erupt, to break the blockage of feelings that has formed into a boulder of tension. So it does not surprise me that a proffession that expects its workers to work a sixty hour week, for little gratitude, is spawning student bullies who are taught not to look weak yet look sympathetic.

      It is impossible to look hard and tough and impervious to emotion and actually feel a feeling of sympathy. And the servitude expected of doctors would burger flip into a grab at entitled demanding, both of these extremes give no space for a middle path of healthy balance.

      • I trained in nursing back in the day. I know the sarcasm that runs rampant through a system that expect its human beings never put their feet up. It is a servile scandal to treat people like machines and then not expect them to see their patients in the same mechanical light.

        On the other side though If I was in some hot inhospitable desert in Namibia and had just come down with malaria I would not give a dam how my hundreds of miles away doctor would look imperiously at me or so. I think in the west we expect medical doctors to be giant cuddly toys.

  2. Character comes down to a question of values – or lack thereof. And mainstream psychiatrists rarely question the VALIDITY of what they do – much less the VALUE of it. And if they do, it’s not much more than a lot of self congratulatory lip service, with psychiatry ALWAYS saving the day!!! And because psychiatrists aren’t burdened with those pesky objective medical tests, they’re able to skate on by…..

    • Birdsong, you always write great comments, spot on.
      There is a mindset among all health care providers that whatever a psychiatrist says/writes or labels a person with, it’s akin to the word of God. If a psychiatrist says it is, then it is, there’s no questioning it by anyone, including other doctors or professionals. There are unethical doctors in other areas of the health care system but it’s clear there’s a major lack of ethics and values in psychiatry. Not every psychiatrist is self-serving, arrogant and unethical but too many are and they are causing much harm and destroying lives. The ones who actually care about patients are in the minority but often too afraid to speak up and remain complicit. Thank God for those who do speak out!

  3. I am not sure why just pick on psychiatrists when this type of behavior is rampant at present throughout the health care system. We have to acknowledge that it is not just the psychiatrists who are not ethical. When we do that, perhaps, things could change across the spectrum of all health care and we might be a healthier nation. Thank you.

    • Well, I pointed out a couple reasons to pick on the psychiatrists above. However, I agree … with this Covid thing, the lack of early treatment, and the bad in-patient treatment with Remdesivir protocols, which killed many. This is pointing out the abusive and criminal behavior of the entire medical industry.

  4. I am puzzled as to why people here zone in on psychiatrists. In the mental hospital I am in just now you can seldom ever find one. The hospital is full of other employees, such as nurses and student nurses and caterers and chefs and porters and mail room employees and occupational therapists and art therapists and cleaning technitians and laboritory microsope gazers and gardeners and carpenters and plumbers and occupational health surveyors and receptionists. Any one of this cast of thousands can be having a bad day enough to unleash bullying. It may not be overt bullying but slipshod indifference to your plaintive call for a tylenol. Magnify that indifference and you start to take the uncaring ambience personally.
    On the other hand many of these workers are diamonds who double as doctors when there is no one answering your room buzzer. These honest workers need the psychiatric hospital to pay their wages so that they do not lose their homes and end up in one as a patient.

    I am curious as to why psychiatrists get singled out as if symbolic monsters in a Grim’s fairytale. I suspect that whilst some of them may well be deliberately hateful, most are just UNABLE to care in any other way they may WANT to care, given the pressure to cure people so fast that they are subjected to. Patients add up to beds and beds need cleared fast for the next onrush of psychotic emergencies. Patients are just a number and yet I know from my short stint in nurse training that you DO go home crying about your helplessness to help a patient whom you can see has simple needs but who is way at the back of an impossibly long long long long long queue. People want to think their psychiatrist is a pill giving thug who does not care but sometimes, not always, I believe this is a darksome fantasy needed to put the fantasist in a pure light. I have seen on the ward I am on people being actually violent towards nurses. Actually violent towards doctors. These workers are doing a job and there is no excuse for violence, from them or to them.

    • Actually, I mostly agree with you. I remember when I was in the hospital about nine years ago. It was not a psychiatric hospital, but a traditional hospital. Some of the nurses and doctorw were quite rude and close to bullying behavior. There were two or three people were quite nice to me; a volunteer and a physical therapist who would take me for a walk each morning. Oh did I mention the food! Later, our neighbor said that that particular hospital is where you go to die. I was thinking as he said that, how did I survive? Of course, when I was in what is considered the “mental hospital” the staff would lie to my mother. They told her that I had a contagious disease that I did not have. And, yes, I have known many psychiatrists were either quite rude or just terribly disorganized or disoriented. Still, it is very wrong to just criticize psychiatrists when much of the behavior exists across the whole health care spectrum, especially in the United States. Additionally, it might get worse as now after Covid, most areas are facing nursing shortages and shortages of other health care workers and professionals. In my opinion, psychiatry does not live in a vacuum. It is affected by the other health care specialities and as those specialities are affected by psychiatry. One can not speak about one without the other. When we acknowledge that, and in actually, the whole big picture, changes can be made. Right now, just zeroing on psychiatry, etc. accomplishes nothing, but maybe more pain and anguish. Thank you.

  5. I read the entire paper as published at ResearchGate.

    Though it is basically a personal and evocative message, I have no doubt that the pressures towards depersonalization in Medicine are very real.

    What is missing from this paper, besides the statistics that you would expect from an actual study (though the high suicide rate among doctors is noted), is any real sense of what is causing this.

    And while an obvious target is our “modern” brand of capitalism, which seems much more exploitative and opportunistic than it used to be, I am not sure that even begins to answer the question. In other words, what drove us here?

    On top of this shortcoming, we have obvious historical realities. The mass slaughter of indigenous peoples by “white” invaders from Europe is documented and generally agreed to be egregious. So was the African slave trade and the Holocaust. And these all were, to some extent, capitalist ventures. And while that history creates a cloud over the “value” of free markets, it does not in the end condemn capitalism as the cause of those moral lapses.

    And since we can find similar lapses in societies that call themselves “communal” (or Marxist), we are impelled to look further into human experience for an answer.

    I believe it starts with the realization that if you enter into a profession or line of work because you want to help or heal people, and then fail time after time to help or to heal, you will begin to feel and act like a fake, like a criminal. I think that’s a big part of what is happening in Medicine. But that doesn’t explain why it is becoming more and more difficult to feel one is truly helping.

    One might be inclined to believe that there must be some sort of self-defeating mechanism built into the human psyche and into human experience. And indeed, such mechanisms have been found. It could be imagined that these mechanisms may be triggered by certain environmental factors. A quiet walk in the woods results in a relaxed if not happy state of mind for most of us, while spending a few minutes in a “modern” hospital room among all the whirring, beeping gadgets and commotion of people rushing to and fro will leave most of us with a sense of considerable dis-ease, if not outright revulsion.

    Though bringing ethics back into the field of medicine may seem like a straightforward idea, when confronted with the human problems that tend to prevent that from happening, it does not seem so easy to accomplish.

    And in the case of mental health, the situation is even more challenging, as while we have a decent grasp of how the body works, most doctors have no clue how the mind works. I would support the proposition of removing medical doctors entirely from the field of mental health. I don’t know if that would be enough to send the drug companies off to find their victims elsewhere, but as long as mental health as seen as a medical problem, I am quite certain that no real progress will be made in the field.

    • l_e_cox asks, “…what drove us here?”

      Two things:
      1. Laws that changed healthcare into Big Business
      2. Technological advances that drove up costs

      “….there must be some sort of self-defeating mechanism built into the human psyche…”

      What’s the mechanism?
      It’s greed for some, survival for others.

      • You’re going to have to think and dig deeper to find real inspiration here, Birdsong.

        Both the spread of large corporations and fancier technologies were created by PEOPLE. So the driving force for these changes must exist in people.

        If you are truly interested in this subject, you should look into Hubbard’s work. We are looking at mechanisms in the psyche that date back millions of years.

          • Well, that’s fine, but I don’t consider greed and survival to be “mechanisms.”

            Survival is an urge shared by most biological creatures and greed is an anxiety or emotional reaction to a perceived (not necessarily real) threat of perpetual scarcity.

            Mechanisms are mental constructs where a stimulus is received and later a response (often considered reactive or irrational) is produced.

            The human psyche normally contains various mental mechanisms that tend to result in self-defeating responses or self harm when confronted by various stimuli.

    • l_e_cox asks, “…what drove us here?”

      Reading the MIA article “The Functions of the Mental Health System Under Capitalism” by Joanna Moncreiff MD explains a lot.

      “Whereas in pre-capitalist societies most people could do some useful work in the community, in the capitalist system labour only has economic value if it attains levels of productivity sufficient to generate profit for the capitalist……The organization of production under capitalism generates many of the problems we call mental disorders…..much of the current mental illness epidemic (that) is so closely linked to financial insecurity, debt, lack of housing, loneliness, fear or feelings of failure and lack of purpose.”

      “Insanity is the only sane reaction to an insane society.”
      – Thomas Stephen Szasz

      • I don’t know what a “pre-capitalist society” is supposed to be. Pre Marx? But I don’t think this answers the question. Why did we choose corporate business and government structures? Why did we agree to it?

        I don’t agree with Szasz, either. Sanity is the only sane reaction to an insane society. Insanity is an insane reaction, as are most reactions. It’s just that the spokesmen for that society will claim the sane responses are insane.

        • l_e_cox says, “l don’t know what a pre-capitalist society is supposed to be….Why did we choose business and corporate structures? Why did we agree to it?”

          I think Dr. Moncreiff was referring to pre-industrialized societies. But some form of capitalism has been around since ancient times. And business/corporate structures evolved along with it. And the reasons were/are to maximum profit/create wealth for the owners with wages for workers. Some people see this as a good thing, while others see exploitation. But going back to your question, “Why did we agree to it?” Because people need to eat/survive and others take unfair advantage of that.

          • And why do some people take advantage of others?
            There’s lots of reasons. Some are greedy, and some are needy. But both are associated with the drive/instinct to survive, which is part of human nature.

          • But it’s not rational to tear down others to “get ahead” is it? We need friendly relationships with others. That’s sanity. It’s insanity that makes people take advantage of each other. Not the “mental illnesses” that psychiatrists pretend to treat, but real insanity.

          • l_e_cox says, “But it’s not rational to tear down others to “get ahead” is it?”

            But you’re dealing with human beings who are never entirely rational. And this includes psychiatrists.

      • Birdsong, With all due respect to your comment and to the author of the article in which you cited. In my opinion, it’s definitely NOT capitalism that is the problem; but that we are now a “technocracy” that is the problem. The problems the author cites and that you quote in your post are actually more representative of our growing reliance on technology, i. e. computer based solutions for everything. This coupled with increasing urbanization make it a hotbed for what really brought us here. Computers, technology, etc. do have their place and can assist so many in leading happier, easier lives but that seems to forgotten in the desire to be bigger, better, the best, etc. This is NOT capitalism. This is human weakness. To the best at anything is not just related to capitalism. How many times we make that mistake, therefore how many times there is no improvement in peoples’ lives. Perhaps, we need to return to the words of the Declaration of Independence, “Life, Liberty, and the Pursuit of Independence.” All of this misguided talk about capitalism and our growing independence on techology as we sink into a technocracy causes a lot of the problems discussed. Thank you.

        • rebel says, “…. it’s definitely NOT capitalism that is the problem; but that we are now a technocracy….This is NOT capitalism. This is human weakness.”

          For some, capitalism means a way of doing business, while for others it means exploitation. And capitalism/exploitation has existed in some form since ancient times, (i.e. slave labor, feudalism, etc.) And technology has changed how we live and do business, in good ways and bad. But while methods have changed, motivations/human weakness has not.

          • Capitalism: “An economic system in which the means of production and distribution are privately or corporately owned and development occurs through the accumulation and reinvestment of profits gained in a free market.”

            We don’t have to be confused about these terms if we use a dictionary. We can talk about how different people have different ideas about what words mean. Let’s at least look them up.

          • l_e_cox,
            I wasn’t confused about the meaning of capitalism as I did use a dictionary. And it is not rational to tear down others, so please don’t assume I’m confused and didn’t use a dictionary.

          • Birdsong, With all due respect, feudalism is not capitalism. According to wikipedia, feudalism is “broadly defined…as the holding of land for service or labor.” It was the main practice of economy in the medieval period. At various times in the history of many countries, since then, including America, variations of feudalism have been practiced, but capitalism and feudalism are not the same and should not be classified as such. Also, it is not capitalism, it is not psychiatry that necessarily “labels those who are unable or unwilling to compete in the workplace.” Allegedly labeling those unable or unwilling to compete in the workplace would require more than just psychiatry. It needs the assistance of other institutions, also. Additionally, the phrase “unwilling or unable to compete in the workplace” to me signifies that psychiatry would be the cause of the alleged character traits that might lead to unemployment. This, in my opinion, is giving psychiatry way too much power that it doesn’t deserve. “Labeling those unwilling or unable to compete in the workplace” is a societal issue that deals with the morals, etc. of a society and culture that would be far beyond the scope of psychiatry. Psychiatry, may, at times, provide assistance to accomplish this, but this whole issue belongs to a society well steeped in some sort of “work ethic” but that too is changing. The concept of “neurodivergence” is partly assisting with that; in addition to technology, and the ups and downs of an economy that has gone through much since the 1970s and before. Thank you.

          • Birdsong, you wrote: “For some, capitalism means a way of doing business, while for others it means exploitation.” Well, that’s confused, isn’t it? I wasn’t saying you are confused. But you seem to think that we are dealing with a level of confusion or “human nature” that we just have to live with.

            Well, does that mean we just have to live with psychiatrists committing crimes against society? The whole motivation behind intellectual efforts is the hope that we don’t have to be satisfied with the current level of “human nature.”

          • All I know is that when I was in my 20s I thought Science must have all the answers, that humans evolved on Earth, and that my best bet for handling emotional problems was to see a psychologist. (Even then – late 1970s – psychiatrists were not trusted as healers).

            Then I found out that there was a huge body of data about life and people that Science (and Psychology) was refusing to look at.

            Refusing.

            Well, I looked at it and I saw that people were using it to get results. So I studied it.

            All I’m trying to tell people here is that that data exists. That the mainstream refuses to acknowledge its existence, and that I think we should be bright enough to study it and discuss it, even if we decide not to use it.

            I don’t think “human nature” is as set in stone as many people believe. The data I refer to totally challenges many basic assumptions of materialistic Science. Studying it changed everything for me. All I am asking people to do is question their own beliefs and see if there isn’t some data out there that might suggest that things are different than they appear to be.

          • rebel,
            Please go back and read what I wrote.
            I said capitalism has existed IN SOME FORM. And I wasn’t referring to the differences between capitalism and feudalism – I was referring to the similarities, of which there are more than a few.

          • rebel,
            Many people see psychiatry as having way too much power that it does not deserve. And many governments in the western world use psychiatry’s labels to legally decide if people are able to compete in the workplace, thus enabling them to receive disability benefits, which means psychiatry has a great deal of power.

          • l_e_cox,
            Human nature exists, confused or not. And disagreement is not confusion, it’s a matter of seeing things differently, which is part of being human, and no amount of intellectualizing can change this.

  6. l.e. cox The problem with all creatures and even plants is that, in so many cases, that which would lead to survival, both of the individual and of the species, can also lead to death and demise. One only need look at the salmon or the lemmings. And think of the flowers that bloom once or twice and then die, the whole plant, that is. Not all species do this. Not all individuals within a species do this. The other problem is that what was adaptive, either in previous generations or actually in the present generation or even in one individual can become maladaptive. One example of this is someone who, previously had no allergies and then, say at age 40, develops an allergy to something. Sometimes, this can be caused by an illness, such as those who have been bitten by a particular tick and then develop an allergy to beef and pork products. One of the errors in our educational and other systems is that we do not guide the individual in discovering what has become maladaptive in one’s life and seeking ways to change it. But that could be because we almost worship all of the maladaptive in an individual’s life, rather than look for the adaptive and its positive effects. Simply, put, it is the negative, rather than the positive we praise daily. So no wonder, we have so many issues to confront in our society and culture. Thank you.

    • Well, rebel, you have presented your understanding oh how biological life works. You present it as fact, which is customary in our language. But the fact is that this is mostly a theory. No one has looked back into the history of plants or animals and actually seen them “adapt” their behaviors or structures to changing conditions. We just assumed that they somehow adapted over generations (in the case of evolution theory) as we see no other obvious explanation.

      When we add an active intelligence into the picture, which can remember from generation to generation and make compensatory changes in form and behavior, we get a different idea of what it means to “adapt.” This is in one sense a theory, but in the case of human beings, is also a tested and workable theory. You can learn this theory and its associated practices, or ignore them. But once learned, they are difficult to overlook.

      In this context, emotion is a mental phenomenon designed to bring the body into action in a sensible response to stimuli. Yet in humans (at least) emotions can be triggered that are not sensible responses to stimuli. That doesn’t mean we should allow psychiatrists to tell us when our emotional response is sensible and when it isn’t. But this does open up various “therapies” that can be employed when this becomes too much of a problem for someone.

      “Science” does not see these theories and practices as “scientific.” They are not taught, tested, or used in academia. So if you depend on academia for your understanding of human psychology, you might never find out about this theory and the practices derived from it. I am only trying to counter that omission.

      • I don’t think that’s necessarily true. “Mental mechanisms” may have zero to do with the body. The “mind=body” equation is central to psychiatry’s worldview, but there is no reason to believe that “mental mechanisms” don’t exist entirely independent from biochemical operations. To use the hackneyed computer analogy, there can be lots of mechanisms in a computer program that are completely undetectable in the physical operation of the machine. From the outside, the computer looks the same no matter what program or calculation is going on. Just ones and zeros and switches and connections. But the code that is run is vastly, perhaps infinitely flexible. I don’t at all believe the mind is a computer or even like one, but I think the analogy is apt. Messing with the “hardware” is a dumb way to solve a “software” problem, let alone a problem with the programmer him/herself!

        • With the mind and body so intimately connected (many mental mechanisms are only there to take care of the body, but others aren’t), there is great tendency to get the two confused. We know the mind is a separate thing from the body because this has been observed in a variety of different ways. But we have never really gotten an image of a “mind.” There are various visualizations and descriptions of what a mind looks like. But in the end it is more important to understand our interaction with the mind, and not exactly what it is.

  7. Steve says, “Messing with the “hardware” is a dumb way to solve a “software” problem, let alone a problem with the programmer him/herself!”

    I like your analogy. It makes a lot of sense.

    I see greed and survival as coping mechanisms/reactions to life’s demands/stimuli. But I find the search for mental mechanisms rather disturbing – almost frankensteinian – as it seems intent on defying/denying the human element – which is akin to bio-psychiatry.

    • I don’t know that I can successfully describe what I’m talking about.

      We are familiar with creating automatic mechanisms in life to handle “drudge” jobs we don’t want to have to think about. Can openers, sewing machines, automated elevators.

      We can do something similar mentally.

      A really simple example would be a machine that responds “OK” when you are asked “How are you?” But say you are experiencing a real emotional or physical challenge and all you can say when someone concerned about you asks “how are you doing?” is “OK!” Now that mental mechanism is no longer operating in your favor.

      There are various ways to dig out such mechanisms and return control to more rational thinking. I know the whole thing sounds a bit mechanical. But how do you think people who want to control us can treat us like machines and get away with it? It has a lot to do with all our own mental machines, but they can be switched off when they stop working for us. Too bad psychiatry knows nothing about this.

  8. Well, to me, it’s just a habitual thing we do with our minds to accomplish something. ‘Survival’ and ‘coping mechanisms’ that you mention would qualify in my view. In my analogy, it would be the equivalent of the “program.” I think there are mechanisms that are conscious and intentional (like how do you drive a clutch car, or how do you make a curried chicken dish). And some are unconscious (like how to deal with someone who tries to make you feel small, or how do you deal with your sister tattling to your mom). I think we get fucked up most by the unconscious kind, because we don’t remember why we feel like we have to “run the program,” but we just know we HAVE to. Conscious ones we can change if circumstances require it (like I buy an automatic!)

    That’s how I think of it, anyway. Don’t mean to speak for lecox or anyone else. It’s definitely NOT a physical universe thing to me!

    • Steve McCrea, Please be aware that there are people who no matter how hard they try, they will never ever be able to drive a clutch car (some call it a straight shift car) and other things, too. For lack of a better metaphor, it is the way some peoples’ brains are “hard-wired.” I, definitely, include myself amongst those… But, the problem with much of psychiatry has been to try change people, who can’t do certain things (and those things vary, depending on the individual, and do not just include the car thing) and then drug them, therapize them, i.e. treat them, etc. trying to make them change and then when they don’t or rather are definitely unable to do that, “make them feel guilty or defective, etc. ” I would use the word, “can’t” but just the use of that word can elicit damaging responses that try to make someone appear lazy or careless or worse, which is very far from the truth. The person is probably trying to work harder than all those so mentioned… Thank you.

    • Exactly! Every “mechanism” has a motivation behind it. Most of them made some sort of sense when we invented them, but aren’t very useful today, or we use them when they aren’t helpful. I think that’s most of what is classified as “crazy” in the DSM, people using coping mechanisms they once found helpful in places where they’re not helpful any longer.

      • Actually the “mechanism” itself is “amoral” and without any real emotion attached to it. It is a “mechanism” about as “mechanical” as humans can be. It is when we humans make decisions about that “mechanism” either right or wrong or the judgment we attach to the emotion that it becomes problematical. One of the issues that most humans face is the vulnerabilty to suggestion. We are all naturally gullible. Take the old story. You go to sick feeling quite well, but for some reason, a co-worker sees you and then asks you if your are sick? (Maybe you wore the wrong color for you that day.) And then over and over you are asked if you feel okay until you start feeling sick and then ask your boss if you can leave because you feel sick. In fact before the end of the day you may end up in the doctor’s office with a diagnosis and a prescription. The most manipulative of the psychiatrists and therapists take advantage of this. Of course, there are those who do it unknowingly too. The main thing, in my opinion, to remember is that we are born with a lot; innate strengths and weaknesses (the mechanism) but whether we use them for good or bad and the emotion or emotions we attach to them only seems to come later after we after interacted with our family, our culture, our society, etc. Thank you.

        • I think that is a very insightful comment. It is the judgment about a particular mechanism adding emotion that seems to make it “automatic” and unable to be rationally processed. There is nothing wrong with having mechanisms to deal with reality. Feeling we HAVE TO or CAN’T or “SHOULD” or “SHOULDN’T” with intense emotion is what gets us stuck, I think. I can say in my own case that learning to view such mechanisms more dispassionately (“What was I trying to accomplish with that approach? Why did I choose to handle it that way? Did it work? If so, what makes me keep trying to use that approach?”) has been what has helped me gain more control of my life.

  9. I totally agree that most of what’s classified as “crazy” in the DSM are coping mechanisms that are no longer helpful. And I also think most psych professionals unconsciously use the DSM as their own coping mechanism to avoid facing their own unresolved conflicts.

    • Alice Miller and I would both agree with you on that last point! In fact, I think one of the very worst aspects of the DSM is that it enables the “professionals” to blame the “clients” for their own (the professionals’) discomfort with the helping process. It is not only not helpful, it seems to me that the very WORST thing one can do in such a situation is to put the client at a distance by providing a label and to call his/her experience “symptoms” caused by a “faulty brain” that need to be suppressed! In actual point of fact, it is almost always the SUPPRESSION of their own emotions and experience that CAUSES their “mental illness” in the first place! Other than “surgery” on the brain, it’s hard to think of anything worse that one could do than the label/blame/drug model that the DSM was constructed to encourage and justify.

      • Steve says, “In actual point of fact, it is almost always the SUPPRESSION of their own emotions and experience that CAUSES their “mental illness” in the first place!…Other than “surgery” on the brain, it’s hard to think of anything worse that one could do than the label/blame/drug model that the DSM was constructed to encourage and justify.”

        Most “mental illness” is the result of painful, unprocessed emotions that psych drugs suppress. And I think most “professionals” use the DSM as a coping mechanism to avoid facing their own painful memories. It’s a massive cop-out, as DSM stands for Denial, Suppression and Mute.

  10. rebel says, “…most humans face…the vulnerability to suggestion. We are all naturally gullible…The most manipulative of psychiatrists and therapists take advantage of this…there are those who do it unknowingly, too.”

    Yes, we are all naturally gullible. And “psych professionals” are among the most gullible, as most have no idea they’ve been subliminally seduced by their training, as their desire to be seen as “the expert” influences most “psych professionals” in ways they’re loathe to admit, which makes it a question of character.

    Steve says, “…the DSM enables the “professionals” to blame the “clients” for their own (the professionals’) discomfort with the helping process…the very WORST thing…is to put the client at a distance by providing a label…to call his/her experience “symptoms” caused by a faulty brain that needs to be suppressed!”

    And this is why the “mental health industry” has no claim to integrity, which is also a question of character.

  11. Birdsong, I read what you wrote. I apologize, if you think I msiunderstood you. I might say we are at “cross-purposes.” This, to me, means, that for some reason, our brains seem to be on “different wavelengths.” I could go and say how much of psychiatry does not understand or even refuses to understand that brains work differently, understand each other differently, etc. However, still, I believe there are some enlightened minds out there, even amongs the psychiatrists, etc. (I am an optimist.) So, please forgive me. Thank you.

  12. Birdsong, With all due respect, that is the very least of my concerns about psychiarty, although this does have effects on the economy. And, it would be better to assist people, if possible, to find “meaningful work” that would allegedly preclude the need for psychiatry, etc. The biggest issue, in my opinion, that psychiatry needs to face is the “drugging”—prescribing drugs like they were penny candy. Therapy, also, as at is practiced, as basically, an adjunct to this “drugging” is also highly suspect, in my opinion. However, until we can find a healthier replacement that treats everyone as individuals with unique individual brains, although we must remember that there are “certain groups” who seem to share similar charateristics, etc. we are basically stuck in this pattern, as it were. Sadly, on this site, in posts, especially, from many who do post, I see much criticism of psychiatry, etc. but very little thoughtful alternatives that could truly help people. As they say, nature abhors a vacuum. Getting rid of psychiatry, etc. without a thoughtful, helpful alternative only leads to the very real probability that something much worse than present day psychiatry could result. The other prospect is that unless thoughtful, helpful alternatives can be made available, just criticizing psychiatry, so vehemently, as some do and yes, it’s very understandable, will only lead to psychiatry strengthening its position, perhaps, if we are not careful with our vehement criticism, a more dangerous version of psychiatry. In my opinion, blaming capitalism for psychiatry is useless, as the rise of psychiatry, really began in the post-capitalistic world we now have in the US and other places in the Western World. Thank you.

    • rebel,
      I agree that the biggest issue with psychiatry is its incessant drugging, and by extension its type of therapy (disease model, DSM, etc.) But the first step is an awareness that there’s viable alternatives to traditional psychiatry, and MIA is that first step for many people. Knowledge is key.

    • rebel,
      Just so you know, I’m not blaming capitalism for creating psychiatry. But I do think it exploits/perpetuates psychiatry’s worst components: its DSM labels and psych drugs. And this happens because psych drugs are one of the economy’s biggest money-makers. And incidentally, I’m not against capitalism — just lies, coercion and bribery — in other words, corruption — which is the key component of established psychiatry and its ever-faithful cohort, the psych drug industry.

  13. L.E. Cox and Birdsong, I agree, in that, part of life’s lessons is to learn to handle disagreements amicably. Of course, sometimes, it is a bigger challenge than other times, so, it is a constant and consistent learning experience and challenge. And, I agree with L.E. Cox, about the “failures” of psychiatry, etc. in regards to “things of the SPIRIT.” I have had similar enlightening experiences. First, I studied psychology and thought it was the answer. But, then I graduated, got my degree, and was still dissatisfied. Thus, I turned to “things more of the SPIRIT.” Then, as life’s challenges got greater and still dissatisfied, I fell into the clutches of psychiatry, etc. twice. Both times, actually, “pushed” into it by “vocational rehabilitation.” But, then, in 2013, psychiatry, etc. due to the extensive drugging, etc. almost killed me. It then took me about two years later before I finally walked away from it. I did have to go through a “withdrawal” period from the drugs, etc. But, now I realize several things; “things of the SPIRIT” supecedes all and is the basis of all the answers (but, of course, it is a challenge to get there and it probably takes several lifetimes,etc.) and when you stop all that incessant drugging and psychiatry, etc.’s present versions of therapy and complete most of the withdrawal period, you return to who you were before all that psychiatry, etc. This is to say, my strengths and weaknesses didn’t change, my character and personality didn’t change. Who I was in the beginning and who I am now is without change, except for the “normal” changes that go with the experience and years of life, etc. It is very difficult to explain. I do not condemn psychology outright or even psychiatry, etc. per say. I can only speak from my limited personal experience. It is not my place to judge others personal experiences, but being only human, I do do it from time to time. As usual, in the wheel of life, there are millions and millions of spokes and each person must uniquely fit them into the wheel of life as it so befits them, not someone else. There is one thing I have learned and that is you can not live someone else’s life. You must live your own or you might be subject to misery and suffering. I think, psychiatry, etc. as it is now presented in the world, etc. does take advantage of that and then seems very reluctant to help people get back to themselves to live their own life and not someone else’s life. Thank you.

      • Birdsong, Thank you. I still have my days. I may have been able to that because I am getting near “retirement age.” Our society, somehow, seems to accept “crazy old ladies.” However, no matte what the calendar says I will never ever consider myself “old.” In fact, my neighbors and friends, etc. consider me “that child that never actually grew up.” But, despite, that I do do my best to keep up my adult obligations—now that can be “real insanity” at times. Thank you.

  14. Dear rebel,
    You’ve managed to keep up your most important obligation: the one to yourself, which is very admirable in this day and age when we’re saturated with infantilizing messages from established psychiatry. And you do this with a curious mind and open heart. There’s nothing crazy or old about that.

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