A Patient Reads His Psychiatrist

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By the morning of November 23, 2013, I went through another sleepless night. The last few nights had been particularly bad as I had been tossing and turning with sweat pouring from me. Whatever brief moments of sleep I was getting were tormented by the violent images of my dreams. My night terrors were a perfect expression of my traumatized mind. My focus had narrowed to the Shakespearean question, “to be or not to be.”

I felt terribly ashamed and guilty for losing my job and jeopardizing my wife’s well-being. She was blaming me for not being able to keep my job. I thought my only chance of making it up to her was by killing myself. I told her that if I died, she could live off my death and social security benefits which would have allowed her to remain in our beloved house. I told her that I thought sacrificing my life for her benefit was a loving thing to do.

That morning, I called our longtime family doctor, to tell her I needed to go to the hospital as I was desperate for sleep. Not getting restful sleep for days was unbearable. By going to the hospital, I thought I would be able to get medicine to break the many nights of sleeplessness. I assumed I would be on a medical unit where I would have a quiet room. I knew from my experience as a mental health therapist that sleep deprivation is potentially quite dangerous.

My wife drove me to the hospital and sat with me as I was interviewed by the emergency room doctor. The note from the ER doctor read that I was a “patient experiencing major depression, suicidal thoughts, constant anxiety, hallucinations, and possibly delusions. He cannot clearly contract for safety, stating, ‘if something terrible happened, I would not be surprised.’ The ER doctor recommends inpatient hospitalization at this time for stabilization and further evaluation. The patient is voluntary and wants to be admitted.

After a bit of a wait in the ER, I was admitted to a locked psychiatric ward. As I was wheeled onto the ward, the door locked behind me, and my life would never be the same. As I entered what felt like Dante’s Inferno a house of horrors my high anxiety morphed rapidly into absolute terror when I was assigned a shared room with a psychotic man who upon meeting me said, “So you’re here to sleep. I’m here to talk to you.” Fear and terror ravaged every cell of my mind and body in an environment that was anything but calm and quiet.

The noise and chaos in the unit were unbearable. Terrified of being confined in the hospital, I was desperate to go home as soon as possible. Dr. W. wrote in my medical chart, “Unfortunately, he has had severe insomnia due to anxiety and has not slept well, or perhaps at all for 2-3 days. Also unfortunately, the only bed available here was on our intensive care unit, where there are currently multiple patients with severe MI who are psychotic, loud, and disruptive, which is about the worst environment for this patient one could imagine.”

By the time Dr. W. was ready to see me, I was severely agitated and feared losing my mind. Within seconds of meeting him, I could sense Dr. W.’s dis-ease and discomfort. I suspected he was told before he saw me that I was agitated and demanding to be discharged. When he introduced himself, his affect was dull and he seemed irritated that I had been begging to be seen by him. He was very impatient with my impatience to leave the hospital as soon as possible. I was on the edge of a nervous breakdown, but there was nothing calming or reassuring in my doctor’s presence. This hospitalist was anything but hospitable.

Dr. W. seemed unaware that the manner in which he presented himself had real-life consequences. Being a seasoned therapist myself, and being exquisitely sensitive, his negative affect frightened me and served as a warning sign that I was in trouble. I felt trapped behind the locked doors of the hospital unit. I resented that he acted as if it was unreasonable for me to expect that he would be kind, patient, and considerate. He had no ability to form a therapeutic alliance with me.

Dr. W. quickly ushered me through a perfunctory suicide screening assessment he had committed to memory. He was trying to determine if I had the desire, intention, and means to kill myself. The way he asked me questions put me in a defensive mindset. To each question I answered, “I am not suicidal, I just want to go home to sleep.”

In a state of panic, I knew I needed to do something to appease his dislike for me so he would release me from his control. I thought I would appeal to his sense that I was a capable mental health therapist who knew what I needed. I told him that for seven years, I had been a behavioral scientist in a family medicine residency program. As a medical educator, I had taught that how a doctor feels about a patient is of great importance and makes a substantial difference in patient satisfaction and positive outcomes. Simply put, no physician can take care of a patient without caring about them as a person. When a physician does not like a patient, they are more likely to be dismissive, inattentive, abrupt, and impatient.

After telling him about my clinical experience in teaching family medicine residents, I said, “I don’t think you like me.” Dr. W. stared back at me impassively and said, “You’re right, I don’t like you. You’re making my job difficult.” His words were said without insight, self-awareness or compassion. His glib response was thoughtless but he did have the presence of mind to not document his caustic words “I don’t like you” in my medical chart. By doing so, he buried the moral significance of his cruel words and presented my alleged “lack of cooperation” as completely unwarranted.

The crucible in which we met was a cauldron of mistrust. I didn’t trust him and he didn’t trust me, which distorted the perceptions and inferences we made about each other. I was agitated, sleep deprived, and fearful; he was annoyed, impatient, and irritated. I didn’t trust him because he didn’t like me and I didn’t think he had my best interests at heart. He felt insulted that I was aware of his negative countertransference.

My medical chart was mostly focused on how he felt insulted and offended by my presence. I quote from the discharge summary: “He was extremely irritable, and was personally insulting to this examiner, repeatedly seeing himself as trying to teach me how to conduct a decent examination, and was very critical of my attempts to do so, while at the same time refusing to cooperate with even a rudimentary evaluation until I could finally convince him unless I was able to do so, I would be forced to place a hold on him because I couldn’t draw any conclusions about his diagnosis and safety. He interpreted that as a ‘threat’.”

Dr. W. was most likely unaware of the large percent of suicidal patients who deny being suicidal when seen by mental health professionals. According to one study in General Hospital Psychiatry, roughly one half of people who have suicidal ideation will deny it if a mental health professional or researcher asks them about it. In addition, about one-third of people who attempt suicide do so in the first couple of weeks following a psychiatric evaluation and hospital discharge.

Dr. W. acted as if mentioning my perception of his affect violated the sanctity of the doctor/patient relationship. His quick dismissal of my words about his affect showed a subtle but important form of unconscious bias. While he complained that I was arrogant, a more reasonable assessment would have considered that I was highly intelligent, well-educated, and insightful, and in that regard, I might have been an atypical or unusual patient for him.

From what I experienced over my 40 years in the mental health field, such attitudes toward distressed patients are anything but rare and unusual. Nonetheless, how Dr. W. wrote about my pain was deeply flawed. He believed my pain was endogenous, a product of my presumed personality disorder. He didn’t seem to have any interest or ability to link my symptoms of despair to the rapidly deteriorating circumstances of my life. In my medical chart, he made no mention of my being unemployed, or my fear that at age 63, I would never find another suitable job.

The story of my suicide attempt exposes the ease with which a well-regarded psychiatrist can inure himself from a sense of responsibility when a distraught person is suffering. My story also exposes the ease with which some mental health professionals are able to suppress their own capacity for empathy and compassion. Dr. W.’s attitude of knowingness, that he knew what he needed to know, was reflected in his repeated claim that he was a “pretty good doctor.” He was more concerned with protecting his professional identity rather than being a good doctor for me.

Dr. W. was unable to accept the fact that he and I were not a “good fit.” Conscious awareness of the autonomy of negative countertransference is not something promoted in modern day psychiatry. In fact, the way that countertransference is typically conceptualized is that it is evoked primarily by the assumed pathology of the patient. This gives clinicians great power and allows them to avoid responsibility for their unkind and impatient reactions to patients.

Unbeknownst to Dr. W., his biomedical orientation to medical interviewing was evident in everything he said to me. The “self-assured” psychiatrist seemed to be completely unaware of why I did not trust him. He never acknowledged that I might have “insight” into what was happening between us. He never considered that I might have reason to mistrust what he had to say to me and about me, especially given the fact that we never established a therapeutic alliance. The only common perspective we shared was that he didn’t like me. His power over me left me feeling exquisitely vulnerable.

Dr. W. wrote his diagnostic assessment as if it was the definitive truth about what happened between us. Though he had been “trained” in psychiatric interviewing, he seemed to be unaware that there are many in the healing professions who have legitimate concerns about his particular biomedical style of psychiatry. I doubt that he had much training in motivational interviewing, reflective listening, and the importance of listening with an open mind to what a desperate patient like myself had to say. He showed no understanding of the intersubjective nature of medical interviewing and that his emotions had any bearing on the quality of our relationship. It was clear that he was annoyed and irritated that I was not a more passive and deferential patient.

Ironically, my estimation of Dr. W.’s core affect (that he didn’t like me) was completely accurate. In a curious twist of fate, I was more in sync with him than he was with me. He was confident but not correct in his assessment of me. He acted as if I had no legitimate right to feel frightened by his words and behavior. To me, this shows an utter lack of understanding of my lived experience as a depressed and potentially suicidal patient. It never dawned on Dr. W. that I might be insightful while still being distraught and desperate.

After he made clear that he would not release me until he “completed” his evaluation, I then focused on saying what he “wanted to hear.” I knew from experience that if I insisted that I was not suicidal, he would be more likely to discharge me. I repeatedly said, “I am not suicidal, I just want to go home to sleep.” That was my standard response to any of his questions. From this, he said that I “contracted for safety.” He took my denial of suicidal ideation as factual when it was not.

He also wrote in my medical chart that my then-wife was not “concerned about my safety” if I was to be discharged. He accepted her statement at face value, without considering its irony, but he never documented what she meant. By the time he discharged me, I was certain that he didn’t care if I lived or died. The same can be said for my now ex-wife. On the day of my suicide attempt (November 27, 2013), she told a common friend, “I can’t believe Michael ‘messed up’ his suicide attempt, I would have been able to keep the house.”

Dr. W. complained that I was uncooperative because I was agitated without understanding that agitation is a significant risk factor for suicide. The late suicidologist John Maltzenberger wrote, “Intense desperation is a mental health emergency.” But for Dr. W., all he could see was an “uncooperative patient” who had the audacity to notice his dislike of me. Dr W. went on to write that he had never met someone so inclined to blame others for his own problems. It seems evident that he was not used to a patient being able to read his implicit bias and negative countertransference.

Dr. W.’s conclusions were neither apt or meaningful. There is extensive research on the high rates of suicide in the weeks following a discharge from a psychiatric hospital. His problem was that he was unable to keep what he felt about me from influencing what he claimed to know about me. In psychological terms, Dr. W. was a naïve realist who believed that he saw me just as I was. In an instant, his solipsism transformed me from an intelligent, caring, and distraught person to a non-person, an unlikable person, unworthy of receiving kindness, compassion, and professional consideration.

His claim that he didn’t like me was absolutely truthful, but his insinuation that I insulted him was completely self-serving. In the midst of my woes, he used professional jargon to isolate and insulate himself from self-examination. Much of his verbal and written discourse consisted of hyperbole, accusations, and distortions. In his defensive state of mind, Dr W. was too jejune to ask himself, “What is going on with me that I am being so unkind to this vulnerable man?”

I felt that Dr. W. did not understand the depth of my despair. He neglected the context and specificity of why I was having the problems I had. It was not possible for me to reorient my psychiatrist so he would become more compassionate to me. He thought it was preposterous that I didn’t think he was empathic.

From my perspective, his problem was that he couldn’t admit to himself that he had no idea how to form a therapeutic alliance with me. For him, that kind of awareness would have been humiliating rather than humbling. I would have had more respect for him if he had paused and asked me with an open mind, “Why do you feel I don’t like you?” I would have also appreciated being referred to another doctor to complete the evaluation. But that would have taken courage and humility that Dr. W. didn’t seem to have.

It is well established in the mental health literature that psychiatric diagnoses are often misused to create an arbitrary and stigmatizing distance between the doctor and the patient. Dr. W.’s description of me, that I was agitated, insulting, uncooperative, did not match the emotions I was feeling. I felt distraught, hopeless, terrified, and desperate, a derivative of the word despair. He showed no understanding that his affective response to my despair made my situation worse.

Dr. W. did not listen with the intent to understand, he listened with the intent to categorize and label; for he made it clear that unless he could give me an appropriate diagnosis, he would put a hold on me. Psychiatric diagnostic categories are intended to reduce the complexity of lived experience for the purpose of insurance reimbursement. Dr. W. would not have been paid for his time without giving me the label he did. Unfortunately, psychiatric nomenclature deflects the crucial links between psychological pain, brain function, and lived experience.

For me, his assessment was more a bureaucratic obligation to fulfill his commitment to the hospital and the insurance company that was paying for his services, than it was to help me. The words he used to describe me were all pejorative. He made no mention of any characteristics that he respected. He lacked any understanding that my experience of suffering was unique to me and that I might resent his feeble effort to fit me into his favored diagnostic categories. Dr. W.’s delusion of understanding, his felt knowingness, was an obstacle that blocked him from understanding me with any reasonable degree of compassion.

Nine years later, I am still amazed that Dr. W. could so easily suppress any compassionate feelings toward me. The truth is he never said anything to me, or wrote anything in my medical chart, that might vaguely be seen as respectful, kind and caring. He made no effort to manage or monitor his negative countertransference, which might have allowed him to consider the iatrogenic effects of his words upon me.

I write not to establish my “innocence” but to understand the confluence of life-threatening circumstances that once held me captive. The relationship I had with Dr. W. is a cautionary tale; a reminder of the importance of all physicians abiding by the Hippocratic Oath primum non nocere above all else, do no harm.

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74 COMMENTS

    • To mister. Robin
      Sir. Incredibly sorry for the horrible experience u endured. I agree most doctors are unaware they broadcast and as u know that fills the room as body language and intent and tone is most of communication. Nothing u don’t know and I’m my experience as well

      They are either genuinely empathetic sympathetic or condescending cold clinical analytical the last what a tense sensitive people or animals need. The later as I work with animals and as I rightly or surely know it’s not the word the animal picks up but the body language and voice tone. I would argue that our inner animal radar is the same and overcrides those who talk logic and

      They clearly have not been ther

      Ur article I echo sad to say. I thank u for posting it as the system is hugely in denial They. The clinicians need to be patients not inlike thd book black like me

      And experience the system for six months. Then meaningful changes will occur. I am not holding my breath of course

      I thank and appreciate u taking the time for ur article. Aplogize for the formality just the way I was trained. Inside I’m impressed thankful
      And huge step in right direction and thankful for this site to publish the other side of the story

      Footnote. I’ve seen outstanding psych doctors and we have stumped for them to no awail as to the system ur always a patient. Part of the problem. No I am a former client who fired his abisive doctor and firing the system that is worse than the condition. At least in my case. I’m not advocating there are not places for medicine to help control or diminish pain and suffering in hands of kind doctors. I’ve seen them and the system doesn’t care what we think either way

      Thank u for ur article. Again so sorry u had to endure the nightmare

      Ur prob much more perceptive and in tune than most clinicians and ice cubes

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    • No, in fact I’ve seen the notes of many doctors who have serious grammatic and spelling issues. Mr. Robin, this was one of the most articulate, most rational, compassionate, and well versed accounts of psychiatric paradox I’ve read (interestingly “Birdsong” was your latest respondent), I’m curious if you were able to obtain sleep in the mental ward and when you were able to leave? Looks like your wife hardly had your best interests at heart, I’m sorry. You were fortunate, at least compared to my experience, that you weren’t medicated, or perhaps knew about the medications before the ‘nice’ doctor bestowed the nasty labels. I voluntarily admitted myself to a NYS psychiatric hospital when I was 26 years old as I too was considering suicide, and will forever regret it. I eventually submitted to the neuroleptics, though I had no idea other than that they were supposed to “make me more susceptible for therapy.” I’ve managed to get off psych drugs, but the brain damage still lingers, it does continue to improve through my continued healthy regimented approach however.

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      • Thank you for your kind comments. I would like to add the following to what I initially wrote:
        “Unbeknowst to Dr. W, I was fully aware of his malignant narcissism. When he repeatedly told me that he was a ‘pretty good’ doctor, it was as if he was in a dissociative state. His claim about his competence was his way of trying to gain my trust. I read the subtext of his words as ‘look, I know I am special, God like, chosen and on the right side of all things, and you’re not. As a narcissist, he couldn’t imagine how anyone could question his competence and benevolence. It was in this context that he claimed I was the most arrogant patient he had met in his long career.”

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  1. Hello, M.R. — I appreciate your cautionary tale. I have been “voluntarily” admitted to psychiatric wards 19 times. I put it in quotes because once I saw what a sham my doctors were, on the wards, I requested immediate discharge AMA – Against Medical Advice — more than once. The responses were along the lines of what you describe experiencing in 2013. One said if I tried to leave AMA he would take me before a judge and demand INvoluntary admission. “Who do you think a judge will believe,” one doctor asked. “You, or me?” I stayed and was eventually put through many ECT sessions that I cannot remember authorizing, and the result was loss of an amazing career in a world renown health center. And because of permanent memory loss, I went on total disability after a few years. Later, I asked for a copy of the authorization I had supposedly signed. They refused. At another hospital, when I swore I was not suicidal (I went there seeking an antidepressant during the pandemic when my own psychiatrist refused to see his patients out of fear of getting COVID) they threatened to call the police. They said once the police arrived, they would tell the police I was dangerous and needed to be committed against my will. Again, what choice did I have but to remain on a “voluntary” basis. Another time I was given so large a dose of antipsychotic medication (my first time to take it) that one of the nurses whispered to me she had never seen them endanger a patient to such a degree. I was unable to even walk to the bathroom or the dining table and they served me dinner on the floor, where I lay. Then they punished me for not properly disposing of my plate and plasticware. I was put in a “rubber room” — I think that was so other patients could not see how incapacitated I was. Never again. Never, never, never. Thank you for sharing your experience.

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    • Dear Donna, Thank you for sharing a small part of what is obviously an amazing story. After ten years of writing, the most common response from my readers is, “Wow, Michael, this is going to help a lot of people when it is published!!” I wonder if you are writing up your story and if you are, I would be honored to read what you have written. I am working on my book and would appreciate being able to share with you what I write. Peace, Michael

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  2. Michael, your article is extremely well-written and a demonstration of how one incompetent psychiatrist can change the course of a patient’s life. Fortunately, you were intelligent enough and aware of what was going on to not be destroyed by this poor excuse of a physician who was clearly threatened by you and certainly in the wrong field of medicine.

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  3. Michael,
    Thank you for sharing your important story. When this can happen to a mental health therapist who tries to get ‘help’ for insomnia due to difficult life circumstances it shows how easily it can happen to anyone. I too experienced a nightmare encounter with a psychiatrist during cancer treatment. The toxicity of chemo and steroids had many adverse effects and also caused persistent insomnia. I was sent to a psychiatrist under the pretense it was for “help with sleep meds”. The psychiatrist was not only ignorant (and yes jejune) but also dishonest and lacking any compassion or understanding of what a person goes thru with cancer treatment. Anything I had explained to her she totally twisted into her own condemning narrative and put 4 psych labels onto my records to discredit me. She even labelled the well-known adverse effects of 3 toxic chemo drugs a “Somatization Disorder”. I soon found out a psychiatrist can be totally incompetent, dishonest and punitive yet whatever they choose to fabricate and put on your electronic medical records will be taken as the ‘word of God’ by all other health care providers and severely affect your future healthcare. Thanks for speaking out and I look forward to reading your book.

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    • Rosalee, Thanks for your beautiful response, it means a lot to me. Since I started writing, the most common response I’ve heard is “wow, Michael, this is going to help a lot of people when it is published.” I would be happy to share other pieces of my writing with you. I’ve been a medical social worker in the past and I know that there are many other medical patients have suffered what you have.

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      • Dear Rosalee, In my forty years of clinical practice which includes being a medical social worker, I am amazed how little understanding there is among doctors treating people with chronic, life-threatening illnesses. Many cancer patients, diabetic patients, chronic pain patients, et al, have significant mental health problems that are not best understood within the narrow confines of traditional psychiatry. Fear, stress, despair, and confusion are not symptoms of pathology. They are a normal response to what are life threatening and life altering circumstances.

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  4. The experiences here are so bad. I’m not shocked but kinda speechless. I agree that you don’t want a Mental Health professional who doesn’t like you. MH professionals shouldn’t be working with people they don’t like. There’s no way it won’t show, affect therapy or harm. When I worked as a caseworker for DSS, sometimes administration did change caseworkers, on a case, based on a client’s complaint. In response, I saw caseworkers taken off the case be really angry thinking the client got their way and they should have the case because they know how the client should be handled. That attitude is a red flag.

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  5. Oh if I could muster the gusto to write my own experiences with psychiatrists that lack all sense of compassion for humanity, I may find some solace. I hope you have by now as just reading this let me know I am part of a special lived experience tribe of survivors. Keep writing.

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  6. This nails it by painting an accurate portrait of the typical psychiatrist in a locked ward.

    One subtle thing that concerns me about this article…..My daughter could easily have been one of the authors’ fellow patients described as ‘psychotic, loud, and disruptive” whom the author found to be disturbing.

    In his desire to be recognized by the doctor as “highly intelligent, well-educated, and insightful” and noting that “I might have been an atypical or unusual patient for him” he shows his own inability to feel compassion for his fellow patients who are acting out emotionally in relation to the psychiatric abuse and carceral oppression they also, have been subjected to.

    I can’t tell if the author is pissed because the psychiatrist did not distinguish between the he, an ‘atypical’ patient and the other ‘loud and disruptive’ patients or because the bio medical trained psychiatrist has nearly nearly zero aptitude to support ALL people in distress, period. I hope its the latter and not the former because the lack of compassion shown for the psychiatrically incarcerated people he left behind is very problematic for me. I do not react well to “Those crazy people are legitimately locked up but I do not belong to that population” That lack of solidarity will not serve us well trying to dethrone psychiatry.

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    • Dear Madmom, I appreciate your sensitivity to words. The use of the words, “psychotic, loud, and disruptive” were Dr. W.s, not mine. After forty years of work in the mental health field, I always try to recognize the common humanity between myself and my clients. Even after my attempt, I was very sensitive to how the other patients were being treated during my seven day hospital stay. More than once, I had staff telling me to mind my own business.

      I certainly did not intend to give the impression that because of my background, I somehow deserved better treatment. I have taught the bio-psychosocial model of medical interviewing for many years. That is what I believe made me an unusual and atypical patient for Dr W. It is also what has made me an “unusual” and “atypical” therapist. When I reported him to the medical board, my case was quickly dismissed with no comment. My intention for the rest of my life is to bear witness to what I experienced. My writing has been very healing for me and I hope will be inspirational to others. I hope other people who have suffered medical abuse will find their own voices.

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      • I realize this may just be my own bias, as I have been gravely harmed by many different types of behavioral/mental health clinicians (not just psychiatrists) but I tend to agree with madmom. As I was reading your article I developed an increasingly bad taste in my mouth. Not only because of the psychiatrist’s deplorable attitude but your attitude was unsettling too. I very much hope you are do not feel as entitled as you sounded in this article. I do not say this to insult or attack you. I say this as constructive criticism. If the book you’re working on reads this way, I would not be able to finish it and I would return it for my money back. However, I can also feel your obvious pain and your righteousness— I believe it to be justified and I scream for you as I do for all of us.
        I see that, “loud, and disruptive” was quoted from Dr. W. But you yourself described your roommate as “a psychotic man”. How do you know he was psychotic? Did you interview and asses then diagnose him? How long did you know him before you diagnosed him? Correct me if I am wrong but isn’t psychosis a symptom, not a definition of who a person is? Maybe a more fair sentence would be a man who seemed out of touch with reality? Or a man who seemed…? Maybe for brevity’s sake you left out a lot of your interaction with this person? Even so, who are you to be diagnosing people? You may be a clinician but you were not there as a clinician. It was not a clinical setting where you were in a position to be objective. Maybe you could reword your description of your fellow patient in a more egalitarian way?
        I also was disturbed by your comments about why this Dr W may have been threatened by you— “highly intelligent, well-educated, and insightful, and in that regard, I might have been an atypical or unusual patient for him.”
        I agree—this is most likely why Dr. W was threatened by you and therefore inappropriate to you.
        However, this part of the article offends me as I also consider myself all of those things. I am intelligent. I am well read. I have a college degree in theatre but in the social sciences as well. I consider myself insightful and have been told by others that I am. Although it is very typical that an inpatient psychiatrist reacts that way to highly intelligent, well-educated, and insightful people these traits in inpatients are NOT atypical to psych wards. It’s seems that you implied it is. That could be seen as demeaning and insulting. A lot of inpatients are all of those positive things and much much more—good & bad. Some of us are not highly educated nor highly intelligent and maybe not very insightful. Does that mean those of us who don’t have those particular traits deserve the treatment you got? Because bel ieve me—they get inappropriate treatment too. I don’t think anyone deserves what we get in the psych wards. Do you? I don’t want to assume you do, but I can’t really tell from this article.
        None of us are JUST what they say our “symptoms” are. How could anyone, doctors, nurses, techs, security personnel nor fellow patients, know all about us in that short amount of time?

        I am trying to write this with open arms and an open mind. I sincerely hope you take my words in the way they are intended —to be helpful and constructive. Not threatening at all. I apologize if I seem that way.
        I want to see my fellow victims/fighters, and I clearly see that you are one of us, of this kind of mistreatment and violence as a united front. We are all equals and I for one like and expect to be treated and written about in that way. I get enough condescension from clinicians. I don’t want to have that feeling from a fellow survivor’s writings, as well. I am not accusing you of feeling this way about me or anyone else. I am merely pointing out that the words and phrases you have chosen to use in this particular article give me that impression. And like I said—I may be biased. I think that maybe I won’t be the only one who feels this defensiveness. So maybe tread more carefully?
        I do get the impression from your article that you think this biomedical system that interprets normal reactions to extreme, dangerous, distressing life circumstances and manipulates them into medical diseases for profit and control needs to be deconstructed. I wholeheartedly agree.
        This system is a threat to civil rights, freedom, due process and democracy to All citizens. The people who perpetuate this destructive system need to be exposed as con-artists and charlatans. They are not gods on high, to be respected and revered. They are just people with letters after their last names, exploiting their fellow human travelers. This desperately needs to be brought to the general public’s attention. How??? I do not know!! I am extremely discouraged and disheartened at this point. I hope you have some suggestions!!! I’d love to hear them.
        I’m very sorry this happed to you. It’s a horrible horrible trauma you went through. I know.
        I’m glad you are invested in this fight. Thank you very much.
        I have written as well. Just one article, so far. My article here is called “I can Barely Breathe.” I wrote it at the beginning of this year 2023. A lot has happened since. I intend to write more.
        I welcome your constructive criticism and communication if you’d care to read it.

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        • You did a great job. And words, the lexicon ised do matter. The DD community waged a campaign against the word retarded and won. The word mongoloidvis notvused as well. So things can change.
          South Pacific’s song You Have to Be Carefully Taught fits in well here. We all and I mean all have let the DSM define our use of words to describe folks. It is always this for any human who ventures into the realm of other. Worse for thise who can be identified by other characteristics.
          My spelling a tag and got worse after my time in psychiatric land well you know because.
          The other point is the hidden eugenics. My parents were fairly open minded but my dad still cane up with the term bad blood. And just being exposed to his thinking despite my own beliefs did plant a small seed so fir otgers whatever but for me still hard.

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      • “I hope other people who have suffered medical abuse will find their own voices.” Maybe MiA should start up a writing group?

        And, Blu, very insightful! The “mental health” “system is a threat to civil rights, freedom, due process and democracy to All citizens. The people who perpetuate this destructive system need to be exposed as con-artists and charlatans. They are not gods on high, to be respected and revered. They are just people with letters after their last names, exploiting their fellow human travelers.”

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  7. Michael Robin is an incredible man and outstanding author. It has been my privilege to be his partner for the past 4 years. How wonderful it has been for me to witness first-hand, his transformation from a life of despair ten years ago, to living a full life today. We are two imperfect people who are perfect for each other. Together, we are experiencing what Joseph Campbell called, “the rapture of being alive”.

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  8. I’m impressed: I always wanted the mean people in psychiatry to fess up and say they didn’t like me, but they wouldn’t. They just would say they were “helping” me and “caring” for me as they tied me down and shot me up with crap. I calm down when folks are truthful; Dr. W! Since he doesn’t like you, he gets to just leave and you get to just leave, right? Since there is an absence of pretense of care.

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    • “Since he doesn’t like you, he gets to just leave and you get to just leave, right? Since there is an absence of pretense of care.”

      Dr W’s professional role was to keep Michael Robin alive. Of Michael Robin, the ER doctor had written, “He cannot clearly contract for safety, stating, ‘if something terrible happened, I would not be surprised.’” Those squishy words of Michael Robin’s, plus Robin’s declaration of expertise in the field of mental health and readiness to tell Dr W how to do Dr W’s job, did not make life easy for Dr W, at all.

      In a perfect world, Dr W would have sized up Michael Robin’s then wife, and the home environment they had together. That home environment appears to have been a major stressor for Robin. An obvious response to a loved one’s saying “I should die so your life will be better” is to say, “No way Jose!! You are not thinking clearly!! and it would not, NOT make my life better.” That Robin’s then wife refrained from any such positive pushback likely contributed to the insomnia and overall distress.

      That Robin had worked in the field for many years suggests Robin should have known how the Mental Health System in this country is organized, and how it works. It may be unpopular to say this here, but, IMO Dr W did their best with what Dr W knew. To me, this blogpost works better as an indictment of the System and, beyond the System, the society over all than as a criticism of Dr W.

      The psych ward was not a good place for Robin. Robin knew that. Dr W knew that. What Dr W did not know and perhaps could not know, was the status of the then wife.

      I am very glad Michael Robin has survived his ordeal, and I guess has a good relationship with a partner now. I hope that, in continuing to reflect, Robin may find ways to assist others who experience difficulties similar to what he had to endure.

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  9. Dear Mr Robin
    I was deeply affected by your written piece . It was like reading something my son would write . Recently he has been in a cluster of poor medicine. He has a medical issue which has been treated however all the hospitalizations he has had psychiatrically have (5) been completely dysfunctional . He is unable to take care of himself for the first time in his life due to poor psychiatric care, especially hospitalization . Finally he has found a psychiatrist who at least cares about and listens to him but he is without a therapist and I know he will never turn for help at a hospital . Thank you for your illuminating article .

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  10. Hello Michael, Your story is heart wrenching. I can relate. I also was an LCSW therapist, trained in 2 psych hospitals, worked for an HMO, and then 35 years in private practice. I experienced some terrible psychiatrists and a few good ones. Mostly I thought psychiatry was a waste of a medical education. Sorry to hear you have had such a bad experience. If you have any left over effects of that trauma, or from life experiences, please look at my not-for-profit downloadable EMDR self-help program at:Se-REM.com. You can write to me with any questions at:
    [email protected]. Take care, David B. (retired trauma therapist).

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  11. I’m impressed: I always wanted the mean people in psychiatry to fess up and say they didn’t like me, but they wouldn’t. They just would say they were “helping” me and “caring” for me as they tied me down and shot me up with crap. I calm down when folks are truthful; Dr. W! Since he doesn’t like you, he gets to just leave and you get to just leave, right? Since there is an absence of pretense of care.
    But this story is not representative of mental health abuse; it is merely a statement of an idiot in the system. Our brothers and sisters are actually locked up for months to years for no crime with no trial. The abuse needs to be made clear and I hope Mad in America will uplift the voices of the incarcerated.

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  12. Reading this narrative, I was reminded of a recent interview on this site with researcher Dr. Morgan Shields, who said:

    “I am afraid right now, there’s not an awareness of the issue, the true issues, and that we’re still debating reality. Is reality, reality? Should we even treat psychiatric patients as people? That’s the debate that I’ve been hearing, and that’s unfortunate. I would love for us to get to the point where we agree these are humans, we are humans, and the way we’ve been operating our mental health care treatment system has been absolutely unacceptable…”

    We really are at the level of trying to convince psychiatry that patients are, in fact, human.

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  13. I only wish I found this the least bit shocking or surprising. Dr. W is not an aberration – he’s the average “clinician” in a psych ward, as far as my experience goes. Someone who shows compassion and caring, let alone even the vaguest awareness of his own “countertransferrence,” would be incredibly rare. In fact, seeing someone act in a compassionate and genuinely caring way is what would shock me. Dr. W is just “business as usual.” It does disgust and horrify me, but it does not surprise me in the slightest.

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  14. Thank goodness this man is now divorced. She damaged Michael at least as much as psychiatry did. And, unlike psychiatry, she hadn’t paid his bills before damaging him.

    This article is required reading for anyone who believes in psychiatry’s BS “expertise” or “care”.

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      • But it is important to point out that psychiatrically “stigmatizing” people to their spouses, and psychologically and psychiatrically gas lighting our spouses, does – most definitely – destroy marriages.

        So like you, Michael, once I’d overcome the shock of my husband’s early demise, and cleaned up the financial mess he and his thieving siblings had created for me. I, too, was grateful my psychologically and psychiatrically deluded husband, was no longer in my life.

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  15. What a heart-wrenching story. As a former special educator, I found I can only spend so many long days with a child with rapidly accelerating antisocial, aggressive, or despondent behavior before considering how my behavior may be driving it. It is so difficult for me to image anyone keeping themselves from realizing that those who challenge their typical practice require something different what what is currently being offered. It’s also confounding to me that these people are allowed to continue practicing without any oversight given how well known the harm professionals in the field can cause when they operate as the final word on their patients’ care.

    My husband had a similar experience in a military hospital, and I had to call our congressman to get him released before more harm was done.

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  16. I agree. Dr W’s behavior isn’t atypical. Very very usual standard proceed stuff. He is accountable and responsible for his reprehensible behavior. But if he did not behave exactly the way he did he would not be performing his job duties. Ultimately if Dr W started behaving like he actually cared about the patients he is responsible for, he would probably be fired.
    Any concentration prison camp guard would be in a lot of trouble if he starting treating the prisoners in ways that were against prison camp policy. (For example—not beating them or being courteous to them) That doesn’t make the guards sanctioned behavior excusable.
    What it means, ultimately, is that there should be NO CONCENTRATION CAMPS!! EVER!!!
    Just like there should be NO mental health system.
    Oh wait, excuse me, it’s more PC to say Behavioral Health System now.
    Interesting terminology huh? More truthful. I like that! (But that’s a
    Whole other article isn’t it?)

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  17. I have been fortunate to spend a number of months in conversation with Michael about his writing on his experience. As a result, I have been able to watch the evolution in what he has done (and presents here in part) as he moves from the absolute rawness of his suicide attempt to a position where he understands it in a new light. That does not salve over the wound; it is deep and lasting. But writing has been a way for Michael to be both in his skin and out of it, to be a participant in all that had transpired and an observer of its impact, and to move closer and closer to his ultimate goal which – in my view – is that the dark land he has crossed and what he has learned in the crossing might be helpful to others. To those who know that land personally, he offers compassionate language. To those who seek to be helpful to the travelers, he offers ideas for them to consider. One of the many things I have learned with Michael is how steep the challenge for professional caregivers to understand that each person before them is experiencing their catastrophe for the first time. Being fully and humbly present to that individual seems critical to knowing what to say – to them, in this moment, no matter how many others have sat before the caregiver, told similar stories. I have learned as an educator that whatever my content, I must know who is in the room with me and learn from them. Then we can explore how what I know connects with what they know, the questions they have, the wisdom we will discover together. Michael’s commitment to this mission to write, as an expert caregiver himself, is fired with love and compassion because he is acutely aware of who has been where he has been.

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    • Thank you Victor. It is wonderful feeling understood and appreciated. Victor and his colleagues Sam and Kiely have been my writing companions these last four years. They are very different from my previous writing teachers. What is special about them is that they are as open to learning from me as I am from them. Together, we appreciate the virtues of mutuality. No singular person is an island unto themselves. We all need to learn from each other.

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      • I agree. We must be willing to put aside our egos and learn from one another. I must remember though that we do all have very sensitive egos. Not just patients. Not just clinicians. We are ALL humans. I must not forget that the Dr. Ws of this world are human too.
        I applaud you Robin. I thank you. The intention of any criticism I have expressed was only meant to further your agenda—An agenda I Wholeheartedly agree with.
        But bottom line—well written. Please keep writing. And good luck on your journey, my fellow human traveler!!!

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  18. When I was in DBT (sent there because I had something called borderline personality disorder, apparently), I was repeatedly told that I needed to use my GIVE skills with treatment providers, told that I wasn’t using my give skills enough. Looking back, I see that as the treatment providers trying to make me responsible for the fact that they didn’t like me (for their countertransference).

    Why didn’t they like me? Maybe because I was honest about the hypocrisy of the mental health system, the hypocrisy of having to fill out worksheets about non-judgmental stance while being called a borderline by the so-called wise and healthy ones. Maybe they didn’t like me because they saw my physical health deteriorating as a result of the cocktail of drugs I was coerced into taking, and since they couldn’t blame that on the psychiatrists, they blamed it on me.

    Imagine if a psychiatrist was ever told that he needed to use his GIVE skills with the patients. (Be Gentle, act Interested, Validate the other person, use an Easy manner). I can’t imagine a psychiatrist on a locked ward thinking it necessary to practice his GIVE skills with patients. That’s only for those at the bottom of the totem pole.

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  19. Such has been my experience, too. My first psychiatrist was compassionate. Unfortunately he swapped practices with one who was still under suspicion of murdering his wife. This one spent much of “our” time together ruminating over that and giving me the url to a website he created about the murder. The rest I had were almost as bad. Some of it is the type of person who is drawn to this field. Some of it is that while most people in their 20’s and 30’s are seeking who they are, these residents are in med school and then suddenly they are out and considered “experts” and have the power over us to damage for life. But mostly, it is the system itself, run by Big Pharma, Big Med and Big Insurance that is killing us. The System likes sheep, even when the sheep are being harmed. Just do what I say, take the drugs and STFU.

    I wish, Michael, that you would write about how you got yourself out of the hole. I’ve fallen, it seems, and can’t get up. Please give us the rest of your story.

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    • Dear HB, I will be writing more about my experience. Four months after my suicide attempt, I met an incredible narrative therapist. My ongoing experience with him is an important part of my story. In addition, I have been writing about how writing itself has transformed my life. I encourage others to write what they can without worrying about the quality. I have revised my writing many times over. I intend to send another piece about my therapist to Mad in America. Thank you for your kind comments.

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  20. Guys like this are why I periodically have become the best “psychiatrist” in my home town without having an MD, because I’m a schizo familiar with nutrient therapy and the shrinks aren’t (I also have a copy of the dreaded Hoffer/Osmond Diagnostic Test to let me know what I’m dealing with, but the shrinks scoff at).

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  21. I find so much hope in this writing. For transparency, I am a person who has struggled with depression, anxiety, and ptsd. I have an uncle who was committed back in the early 80’s and within 48 hours of his released killed his three children and himself. I am also Michael’s barber.

    I really hope that this is a jumping point for Michael to tell the rest of his story and insight. it feels like a very honest approach to telling the story of part of his tipping point.

    Michael’s experience so much that not many people have and come through it all into a place of such joy. His professional analysis. I am always amazed at how a man with such a great analytical abilities and practice could find such emotional positivity as the result of his experience. (I always though analysis and logic would be the tools and rewards of my work with my therapist.) Wait until you get to understand his relationship to his current therapist!

    I feel like i have a bit more understanding around what could have gone on with my uncle in the events that led up to his suicide, both in his mind and his time in the hospital, through this article. But of course I’ll never know.

    This writing and the dialog that has been happening here in the comments has made me realize several new ideas about how people, especially in their toughest moments, bring what they can from their previous experience to try and save their own lives while they are on the brink of chaos. Possibly for better or worse. With Michael’s background in mental health work, of course he brought that with him to the hospital. I’m sure the combat vets use their experiences and training as well. I think of what my uncle, a traumatically introverted man, may have brought. I think of the tools that I bring to my own therapy and problems in my daily life. I wonder if they get in my way or as in this case do they give me a perspective that can help others? Mostly, it brings to mind that compassion and connection for another’s situation can only better any situation, and that nobody’s tool kit’s the same as mine.

    I laughed a survivor’s laugh at the simplicity and deadliness of Michael’s roommate’s greeting “So you’re here to sleep. I’m here to talk to you.” Thanks for that, Michael. It helps me know that I am not the only one who has hit that point where even though it may be completely unintentional or I can logically understand a situation, it’s that tiny trivial moment can be the final emotional straw. So well written.

    Aside: I’m no health care expert, but I can tell you that the guy who comes into the barber shop once every 4 months and talks about nothing but how much he hates being in a barber chair and having to come in to a barber shop isn’t getting the best conversation or most perfect haircut from me. But at least I keep him in the chair for as short a time as possible! And he tips me! And he comes back!

    When I see Michael’s name on my appointment list, however, I know I’m going to get a boost of joy and hope in my day!

    Just another thought this piece sparked.

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    • For whatever reason, I do think it’s hard for those who’ve never been defamed with a DSM disorder, to admit to the systemic fraud and crimes of psychology and psychiatry. But the systemic defamation of character of millions of innocent children and adults, with the scientifically “invalid” DSM disorders, is quite appalling.

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    • Oh, Michael, I’m sorry for the confusion. I’m referring to another customer when I told the story of the guy who comes in and complains. It was just something that your story made me think about. Even though that customer hates coming in, I try to give him what I can based on my compassion for him . . . a haircut that is faster than it is perhaps good.

      You’ve never been anything but a joy to have in my chair. You’ve never been negative about anything. You are grateful and I love our conversations and I actually take extra time not just because i want to give you the best cut possible, but because I love our conversations. Because of our connection.

      You and the complaining customer are on opposite sides of the coin. Just like your current awesome therapist is on the opposite side of the coin from Dr. W.

      Again sorry for the confusion.

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  22. Was I four, five?

    SMASH! CRASH!

    “It’s alright, Thomas, Lovey: I never liked that cup anyway!”

    “Ah, Vera, that was your favorite porcelain cup! Thomas, you need to be more careful!”

    “Ah, Denis, Love, he didn’t mean it….”

    Would I have turned out even more or much less of a prat if my mom had gone on convincing me I could do no wrong, or no harm, willingly, deliberately, knowingly, wittingly, and if my dad had been more instantly forgiving? I can only guess. And my guess is that the more I second-guess myself, and the less I trust myself, my nature, “my Creator,” my heart and my good intentions, the worse a prat I am – or, at least, behave.

    What is the first thing to know about being a doctor?

    Does any doctor know?

    Does anyone know?

    Can anyone say?

    Perhaps it is simply that we do not possess peripheral pain-receptors:

    physical pain = sensation + the emotion of fear;

    psychic/emotional pain = fear;

    and that fear/negative emotions can create not just painful sensations but real disease, too?

    And that the antidote to fear/resistance is, obviously, surrender, acceptance, unconditional love?

    https://www.youtube.com/watch?v=0VyH1laOd2M

    I cannot see how any human doctor could possibly have abided by “Non nocere!”, or honestly expected to do so, however hard they tried to avoid doing harm.

    Ironically, indeed, if/when they tried hardest to avoid doing harm or being recorded as having done harm, seeing as a cover-your-ass attitude is hardly conducive to best – to most loving and healing – medicine or therapy.

    I reckon I am far most likely to make mistakes when I am feeling nervous, anxious, fearful and defensive.

    And I can see how asking anyone to swear any such an oath can be offensive, insulting and/or counterproductive.

    We can hardly mandate a loving attitude.

    “Faith/love/hope can be caught, not taught.”

    And, if ever there was a man, Jesus, who was a great spiritual teacher, I very much doubt he could have instructed,

    “Hey! Yew! Love your neighbor as you love yourself!”

    I reckon he’d have been far more likely simply to have observed that, being human,

    “Hey, you love your neighbor as you love yourself,” for that is our very nature.

    And, likewise, to blame, project, countertransfer and see moats rather than beams etc.

    Insofar as “Primum non nocere!” or “First, do harm!” means “Do not make a mistake!”, well, what honest human being would or could so swear? And yet how many have refused to do so?

    Is there anywhere a therapist who can say he/she did no harm – if only out of ignorance, forgetfulness, thoughtlessness, distractedness, provocation, impatience or neglect?

    https://en.wikipedia.org/wiki/Hippocratic_Oath

    https://www.aamc.org/news/solemn-truth-about-medical-oaths#:~:text=While%20nearly%20all%20U.S.%20medical,and%20growing%20%E2%80%94%20range%20of%20oaths.

    I feel very grateful to Michael for his account of his experiences, and for how they have spurred me to reach out in love to all those “mental health,” professionals who probably believe they did me very grievous harms but also that they have had absolutely no avenues open to them to apologize, atone or make any attempts at restoration for any of those harms – any more than to otherwise earn a livelihood, let alone to seek alternative, truly healing careers.

    Only by so reaching out to them, and, in my books, writings, performances etc., by doing my own best to explain why I truly believe there never even is anything TO be forgiven, but only understood and avoided, and how well I understand that every single human being that ever was or will be is always doing her/his very best, at the time, do I believe that I can possibly do my own best to dissolve coercive psychiatry.

    To the extent that I have neglected to do this until now, am I any less culpable than my worst persecutors?

    I love Max Ehrmann’s poem, “Desiderata,” which includes the following lines:

    “Beyond a wholesome discipline,
    Be gentle with yourself.
    You are a child of the universe
    No less than the trees and the stars;
    You have a right to be here.
    And whether or not it is clear to you,
    No doubt the universe is unfolding as it should.”

    If any universe in which I find myself is indeed unfolding as it should, then presumably all my own real and/or seeming slips, errors, accidents, “sins,” and transgressions must surely have been essential to that precise unfolding?

    If, then, those errors resulted not so much from my own intentions and will as from that of Ms Universe, then they may very, very well represent my own best work, to date…and the same must apply to all the grave medical and other errors involved in the abuses heaped upon me.

    To err is divine; to forgive, human.

    ‘In all chaos there is a cosmos; in all disorder, a secret order.” – Carl Jung.

    https://tiplr.com/tips/europe/ireland/a-mysterious-ley-line-between-ireland-and-israel/

    Cosmically speaking, how could there be any mistakes or accidents, what Murray Gell-Mann says notwithstanding?

    Minute 14:43:

    “Life can emerge from physics and chemistry, plus a lot of accidents. The human mind can arise from neurobiology and a lot of accidents, the way the chemical bond arises from physics and certain accidents.”

    From

    https://www.ted.com/talks/murray_gell_mann_beauty_truth_and_physics/transcript

    And, however unsympathetic their behavior, at times, if even one of us is not equal then…

    “…for we are all as God made us, and frequently [also rendered as “and many of us”] much worse.” – Sancho Panza.

    Thank you very much indeed, Michael and MIA for all this.

    Very best wishes.

    Tom.

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  23. Michael,

    Thanks for the well-written sharing of your lived experience. When it comes to suicidality, many clinicians are woefully ignorant of the fundamental theories coming from the suicidology community.

    The JCAHO published at least two separate warnings on the unacceptably high rates of suicide in hospitals. Despite this, we continue to pull many people from their social support systems–often to far away facilities due to lack of beds. Social connection is undoubtedly one of the best suicide prevention measures we can have. Additionally, suicide assessment tools are well-known to have poor predictive value and are riddled with false positives.

    The Italians seem to have figured much of this out in their healthcare system, with decreased suicide rates, fewer mental health professionals overall, and less GDP devoted to healthcare. Hospital admissions for suicidal ideation are comparatively rare in Italy versus the US, whose suicide rates have trended upward for decades.

    The road to better health is long and winding. Thank you for paving a small portion.

    With gratitude,

    Chris

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  24. Thank you so much for sharing your deeply insightful stories. Reading you has felt tremendously validating and empowering. Having been diagnosed with depression at the age of 13, and now being 32, and having experienced multiple crises along the way including a suicide attempt, I’ve experienced my fair share of invalidating and demanding encounters with various professionals. It wasn’t until 2021 that I finally put words to my experience in a blog, writing about how much I felt that something about the diagnosis just didn’t feel right. Two years later and after a journey with compassionate therapists and exploring larger concepts, I now understand how reductive the diagnose was and how little understanding and respect I have been given for the complexity of my experience and the multitude of external factors that contributed to it. I work as a Nurse Practitioner I’m Canada and I have to say that I find it difficult to remain compassion with my patients especially within the constraints of the medical system and my medical role and obligations. I feel shame that I recognize myself in some of Dr. Was behaviors. There is truly such a culture in our biomedical system that is hard to escape and I am constantly seeking connections and support to validate both my personal and professional struggles, and to help me show up differently in both, with more presence, awareness, humbleness, patience and compassion. Thank you again

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    • Dear Michele, Thank you for your beautiful reply. There is nothing more delightful than being appreciated by another human being. I am thrilled that my words touched something deep inside of you. After many years in the mental health field, I know that there are many practitioners, but not all, who have difficulty seeing themselves empathically in their patients. All too often, professionals are taught to define themselves as separate and distinct from their patients. But who among us does not have a wounded soul. Peace, Michael

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