The Emperor’s New Clothes? The Psychiatrist as Expert in a Post-Modern World

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I propose in this essay to question the pre-eminence of psychiatric opinion, the accepted notion that psychiatric clinical experience is the benchmark of valid mental health symptoms, and suggest a pathway towards lasting and effective treatment.

The first myth to tackle is that of psychiatry as just another medical specialty resting on the laurels of scientific and professional credibility. Like orthopedic surgery or cardiac medicine, modern day psychiatry imagines itself as objective, value-free and neutral. However, whilst a fractured femur may be reliably diagnosed in Cairo or Los Angeles, psychiatric diagnoses—let alone treatments—are contested entities. To wit, the furor around Moncrieff et al.’s paper questioning the serotonin deficiency theory of depression, with psychiatrists from both sides lined up against each other. What is the poor patient to make of it all? They are supposed to defer to the authority of a psychiatrist who it appears is unable to resolve even a basic question of the received wisdom of “chemical imbalances.”

Vector illustration of a man with a maze for a head with someone confused inside it

Secondly, we can query whether psychiatrists are indeed the experts of the mind they purport to be. Whilst psychiatric training gives lip service to the so-called bio-psycho-social model of mental illness, most visits to the psychiatrist’s office will inevitably end with you being prescribed medication, which betrays the biological bias of most of the profession.

Given the acceptance that much of conscious life is moved by unconscious conflicts and dynamics, it may surprise the reader to know that there is no obligation in training for the psychiatrist to have their own therapy and, indeed, once qualified there is no requirement for them to have ongoing personal supervision. This may explain why unhealthy dynamics are sometimes set up between doctors and patients where the doctor may be seen as either the rescuer or punitive parent and these re-enactments can lead to very destructive outcomes mostly for the patient through over treatment or stigma.

Thirdly, a frequent defence of the specialty from both within and without psychiatry is that, unlike other disciplines, it is an alchemical blend of art and science. However, is this so? A psychiatrist’s scientific credentials often rest on a reliance to critically appraise data in psychiatric journals or be up to date with the recent evidence-based medicine (EBM) offerings from national guidelines or the Cochrane database. Even if the psychiatrist were to avert his gaze from Big Pharma’s octopus-like reach into almost every aspect of drug trials and somehow plead ignorance of the many adverse effects only reported in publications like this one, there remains the very thorny problem of external validity. Because of the often very strict inclusion and exclusion criteria of many trials, the patient who apparently gets better in clinical trials hardly bears any resemblance to the complex, “complicated,” “treatment-resistant” patient sitting in the psychiatrist’s office, so even if a treatment “works” in a clinical trial it is unlikely to do so in real-world settings.

So, this is where the art of psychiatry surely comes into play? Alas, whilst the psychiatrist might be seeing thousands of patients, accruing his clinical experience, he may be making the same biased evaluations thousands of times. There are a litany of cognitive biases that masquerade as clinical experience, such as the availability error, where the doctor remembers a rare but vivid outcome but then generalises to all the patient he sees. A very good example of this are the many unnecessary hospitalisations of those diagnosed with borderline personality disorder who present with self-harm. If a doctor had a patient he discharged try to commit suicide he is likely to be supremely cautious thereafter, even at the cost of depriving the liberty of the patient in front of him. To add insult to injury, AI machine learning programmes have even been shown to be superior to a psychiatrist in accurately assessing risk. Final analysis: Far from being an expert, the psychiatrist may, like you and me, be subject to a number of unexamined cognitive biases.

Fourthly, the new phenomenon of the democratisation of diagnosis, through direct-to-consumer advertising, user websites, and social media platforms; this has led to a much more assertive patient who presents to the psychiatrist what they think is wrong with them and what treatment they would like. To be sure, this bottom-up movement can be critiqued, but prima facie, this egalitarian, collaborative movement needs to be engaged with and shockingly subverts the power hierarchy that has existed for decades between the doctor and patient.

Fourthly, there are forces beyond the doctor and patient that underpin the mental health field. Edward Shorter described the phenomenon of a “symptom pool” in which he argued that in different eras certain diagnoses are more prominent based on cultural and social mores. For example, in 19th century Europe, hysterical paralysis was an extremely common disorder of women. We may speculate that the disempowered second-class status of women at that time meant that to be taken seriously—or to be seen as validly ill—they developed paralysis. Given the progress of women’s rights over the ensuing century, this diagnosis has virtually disappeared.

So, in this day and age of incessant phone and online consumption, of virtual identities and avatars being created, could the symptom pool now include ADHD, autism, and dissociative identity disorder, given their exponential rise in the last 20 years? This is not to say that the diagnoses do not exist, but rather they are idioms which the culture at this time permits as appropriate expressions of mental distress. It behooves us to zoom out and examine these socio-cultural trends rather than individualise and pathologise those trying to carve out meaning in an epoch of bewildering change.

Finally in highly unequal societies, especially in the West, those living from pay cheque to pay cheque are subject to intolerable pressures that aren’t sublimated through community engagement and inter-dependence as cultural messaging deifies self-reliance and “you get what you deserve” mentality. With no creative, hopeful avenues open to them, the disenfranchised have access only to the crumbs from the high table of the one percent, which amounts to mollifying psychic pain through biological explanations such as a psychiatric diagnosis and therefore a biological treatment: medication. You see, you are the problem. Not the obscenely rigged society. Nothing to see here. The psychiatrist in this iteration may be stormtroopers for post-capitalism.

So how to get out of this morass and, more urgently, what healing space can psychiatry hold? Before that, I would make the following defence for my profession. With the important caveat of experiments like Soteria and Kingsley Hall, and contemporary grassroots movements like Hearing Voices Network, no other discipline from within medicine or without has stepped forward to deal with the very varied and complex expressions of mental distress. Indeed, whenever a non-psychiatrist is seeing a patient who expresses suicidality or thoughts of harming others or displays disordered behaviour, they are immediately sent to be seen by a psychiatrist. That then is a negative defence. A more positive one is that, especially for a psychiatrist who works in the public sector, they have they have seen and treated a vast array of people with mental health symptoms often in a multidisciplinary setting and have developed the resilience and sanguinity that working in such extreme environments requires.

So, we are stuck with psychiatrists. How can the practice of diagnosis and management be improved?

Primarily from both psychiatrist and patient, diagnosis should be seen as a verb rather than a noun. By this I mean, for example, “depression” can be seen as a fluid, ever-changing process rather than an ossified, unchanging cell that the patient is condemned to. After all, DSM-5 diagnoses are lists of symptoms assigned to syndromes that are voted into existence by a vanishingly small amount of mostly white, middle-aged American men, rather than phenomena that exist in nature. This opening-up of the diagnosis allows more agency for the patient and alternative narratives to be considered, whether they be existential, familial, cultural, or social

I also insist that psychiatrists be monists and treat the unity of a human being rather than parcelling out mind and brain. Psychosomatic medicine, the inflammatory theory of depression, and the importance of the microbiome to the healthy functioning of the body all point to the unity of the mind and body. A psychiatrist therefore should be as interested in the physical health of the patient as her mental health and be open to the bidirectional flow of information between the mind and body. Siloing mental illness to psychiatry is deeply problematic both from a philosophical and a pragmatic point of view. This will definitely require the psychiatrist having to improve their medical knowledge but also be open to training in nutrition, psychotherapy, body treatments and other ontological enquiries into the nature of Being (e.g., spiritual, religious, psychedelic).

Enshrining the importance of the relational, the subjective, and the unconscious, I think it would be hugely beneficial to a patient to be able to see a written short biography of various psychiatrists they are going to see rather than their training and sub-specialties. How useful it would be to know if your psychiatrist was interested in multiculturalism, had his own psychotherapy, or is particularly motivated by neuro-chemical theories of illness? This will then allow a match between the patient and the doctor and a shared understanding rather than the doctor trying to shoehorn a patient into a biological theory of mental distress.

Finally, psychiatrists should use their power as respected and privileged members of society to open up the discipline to community engagement and initiatives to improve the social economic difficulties of much of their patients. To begin with, how about charging patients in a measured and appropriate way rather than aping the exorbitant fees charged by other specialties?

In closing, above all humility and doubt should serve as the north star of the profession. Psychiatry has fallen to too many fads and heinous abusive treatments over the decades to hold any of our current treatments with any confidence. As Trudeau said in the late 19th century, the prime aim of the doctor should be “to cure sometimes, to relieve often, to comfort always.”

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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26 COMMENTS

  1. I’m sorry, but your essay seriously under-appreciates the many obvious gaping holes in psychiatry and what you believe is a critique of psychiatry is actually embarrassingly and excessively affirmative. You have not grappled with or assessed the serious issues at all, and haven’t exposed the full scandalous picture so you are actually still producing propaganda for the industry by giving it way too much intellectual and moral credit. Please don’t think I am using extreme language here.

    So let’s look at the basic issues you’ve completely skirted over. What evidence is there, what actual scientific evidence, that what we call mental illness is the product of any kind of neurological or neurochemical abnormality that arises as part of a pathological process? Because on this ASSUMPTION the whole expertise of psychiatry rests. Absolutely none has been found, and even though this or that paper is sometimes dug out to try and put forward an argument for a biogical cause, close inspection of the papers invariably show profound weaknesses in the paper or more usually, a total misappropriation or misrepresentation of their findings. You would know this if you had bothered to do this research for yourself, as Robert Whittaker has famously done. Absolutely essential to psychiatry in it’s present form is the idea that something is wrong with the brain – you can’t deny that, otherwise the psychiatrist would be concerned with the social and environmental factors when treating the illness. And this is the whole basis of their alleged expertise. The only other field of expertise is in observational experience of people who present themselves as mentally ill, but psychiatry makes scant use of this expertise except in concocting new ‘mental illnessess’ which are entirely social constructions which psychiatry and the APA passes off as scientifically elucidated in some way. The only thing psychiatry treats is the brain, and there is no known disease process to target so these drugs are not medicines but drugs like recreational drugs except producing clinically useful effects from the point of view of psychiatry rather then subjectively beneficial effects according to the recreational user. You can’t deny any of what I’m saying here. So there is no known disease process and no evidence has been found for any kind of biological process behind any non-organic mental disease despite 60 years of research. And the explosion of not just diagnosis but DISABILITY due to mental health across the Western world cannot, obviously, be explained by biological or neurological factors: it can only be explained by social factors, regardless of what they might be – you simply cannot deny that obvious fact. We haven’t had an explosion in neurological pathologies – if there are any neurological derangements in what we call mental illness they have to arise from the social and psychological environment, the psychological environment being determined by our social conditioning.

    So is there ANY EVIDENCE WHATSOEVER that ‘science’ and ‘medicine’ is even located in the right terrain? Because the only terrain ‘mental illness’ is known to occur is in consciousness. It has not been detected anywhere else, even though it clearly goes hand in hand with the state and health of the body and brain. We know that emotions and stress effect neurology, hormones, metabolism and physiology but we have not the first clue what consciousness or emotions or imagination or non-ordinary psychological experiences are, and to pretend we do know, and to assume they are of biological and evolutionary origin, is not science but theoretical speculation of a type that belongs not even in the philosophy of science but in speculative philosophy, which is not dealing with facts at all.

    I’m afraid you are just not nearly critical enough of psychiatry and not nearly well versed enough in the actual absence of any relevant expertise in psychiatry besides being aware of the outward presentation of countless forms of the psychological and perhaps neurological and physiological injuries of a brutal and stupid social system that has caused a rise in every kind of psychological and behavioural problems you can think of, including not just ‘mental illness’ but addiction, mass shootings, every form of vampirism, demonic and insane politics and conspiracy theories – every kind of dysfunction you can imagine. Mental illness was about blaming the pathologies of social life on the victims, on those crushed and destroyed by this social life, and the paradigm simply has not stood the test of time. Both scientific evidence and cross-cultural analysis and social analysis and actual perception all have undermined the lies of the bio-medical model and are revealing that these are social injuries. I would say obviously they are related to the social conditioning of the brain by a radically evolving social environment which is a total transformation of our whole physical and psycological environment in the absolute blink of an evolutionary eye. Of course the infinitely complex body and brain which has stayed more or less stable for hundreds of millenia cannot be blamed for this explosion of psychological distress and dysfunction. Obviously the fact that there is a crisis in human health on every level – social, psychological, environmental and physical – cannot be blamed on Mother Nature or biology or the magnificent human brain. It can only be blamed on the accumulated dysfunctions and pathologies in the social milliue which conditions, constrains, coerces, confuses and destroys the delicate neurological, biological, emotional and sensuous substrata producing confused and ignorant and frightened, isolated and unfulfilled human beings who create a social reality out of that confusion and ignorance and illusion etc and design education systems and bring up children through that ignorance and confusion. All this social insanity, dysfunction, destruction and confusion is obviously the product of our social conditioning because it simply does not exist in nature.

    One day you’ll realize that psychiatry is a quite unbelievable and absolutely enormous, incalculable crime against humanity that resulted from our ignorance, our over-zealous scientific materialism, and our greed, and like tobacco and oil the slow adjustment to the facts are wholly attributable to vested interests for which a billion brains across the world are being unwittingly damaged and for which billions of dollars are flowing out of every country on Earth including the poorest to drug companies for what is actually a total scam. Now please, who will doubt the picture I am painting in words? Speak up if you dare. I say this is the truth and deep down you know it. Where’s the proportional emotional response? Perhaps we can’t admit it to ourselves because the scale of this is too much to bare, and relates to all the other enormous problems in human civilization a number of which look certain to destroy us, on varying timescales. I predict that the stages of total global social collapse have already clearly, manifestly begun, and I’m not the only one to share this certainty, and believe me this view is not just held widely in America but right across the world.

    I stand by every word of my analysis of psychiatry and of your essay: I submit that it is the plain and obvious truth. I cannot doubt it because it is in the removal of my prejudices and socially conditioned assumptions that the full and clear picture emerges. Now, can you do the same and just meditate on the known facts, including the facts about what we don’t know? Unfortunately, you would need to acquaint yourself with those facts first, and no amount of theoretical speculation is ever going to help you to do that. It will only produce noise and confusion that drowns out these essential, these profoundly important facts. Please Mad In America – if we don’t up our game considerably it’s all so definitely in vein.

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    • > “these drugs are not medicines but drugs like recreational drugs”

      Yea. So, I thought the exact same thing: why is this ‘medication’ making me feel like I’m on Ecstasy? for example. I started having panic attacks going onto the ‘medication’ and thought: surely, this can’t be right, as I looked through the legal document in the packaging.

      > incalculable crime against humanity that resulted from our ignorance, our over-zealous scientific materialism, and our greed, and like tobacco and oil the slow adjustment to the facts are wholly attributable to vested interests for which a billion brains across the world are being unwittingly damaged and for which billions of dollars are flowing out of every country on Earth including the poorest to drug companies for what is actually a total scam.

      I sincerely hope that Gen Z and younger won’t have to deal with these Pharmaceuticals. I’m a millenial (38), and I will have better access to Menopause Hormone Therapy when the time comes. MHT will be better-researched, too.

      You know, the blood-brain barrier is there to protect us from alcohol, cigarettes, weed, street/hard/party drugs. The fact that these Pharmaceuticals cross that protective barrier and wreck havoc is very unfortunate, very unethical, and medical malpractice, since it’s operating on a debunked hypothesis. People online are justifyably angry for being mis-Dx’ed, poly-drugged, and losing housing, jobs, reputation, hobbies, spouses, etc.

      > Perhaps we can’t admit it to ourselves because the scale of this is too much to bare, and relates to all the other enormous problems in human civilization a number of which look certain to destroy us, on varying timescales.

      For my mom, she vehemently believes the chemical imbalance hypothesis–>medication to fix/restore/keep high. I can see it in her tone, cadence, body language, etc. I can literally see the wheels turning and her realizing that she was told debunked information and that her offspring has been seriously harmed by modern medicine. It’s such a very serious thing to come to terms with, and I don’t think she ever will.

      > I predict that the stages of total global social collapse have already clearly, manifestly begun, and I’m not the only one to share this certainty, and believe me this view is not just held widely in America but right across the world.

      We’ll adapt. People are still having kids just fine. I do my part and avoid animal agriculture as much as I can without getting sick (Northern Italian ancestry.) I see that a lot of people with Norwegian/Scandanavian ancestry can be vegan consumers without difficulty. I can consume vegetarian, and I can keep believing animals deserve body autonomy just like humans do. That’s the best my body can get away with. In acute withdrawal and protracted withdrawal (flair-ups, I guess you could say,) your nervous system will tell you what it wants to eat anyway.

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  2. How and why would psychiatrists do any of the recommended things in the essay? There is no financial or professional incentives to do any of them, and in fact involves massive incentives to maintain the status quo, which meets most of the needs of most of the psychiatric workers with no change whatsoever. Those who DO challenge the status quo are generally attacked and humiliated and threatened with loss of status or income or both if they continue their sacrilegious ways.

    Psychiatry will continue to oppose any sane efforts at reform. I don’t believe it is reformable, as it is at its core based on faulty assumptions that are self-serving and self-perpetuating, and no one will be able to change its basic purpose, which is NOT to help its clients have better lives!

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    • Earth realm: “Amen”.
      American social realm: “I agree”.
      English upper class social realm: “Quite so”.
      English working class social realm: “Innit!”
      Demonic realm: “Isn’t it kanisenit (disn’t it blisn’t it). Isn’t it kanisenit (disn’t it, blisn’t it). Isn’t it kanisenit! (Disn’t it – blisn’t it.) Isn’t it kanisent it! (Disn’t it blisn’t it! Disn’t it kanisenit. Isn’t int, blisn’t it! Disn’t it kanisenit!) Zzzzich. Innit.”
      Angelic realm: “Falalalala – Ohm Ma – Ohm: Ananda Maya!”
      Realm of the nature spirits: “Ah yeee azamahayi. Ah yeeeee ohhhhhm ziamahoo i, eeya mahoy ohm.”

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    • > “which is NOT to help its clients have better lives!”

      A lot of people are furious, and rightfully so. But I personally don’t believe Doctors and Psychiatrists have malice intent. They’re not being given updated research by Dr Mark Horowitz, Dr Joana Moncrieff, Dr Josef Witt-Doerring, Dr Peter Breggins, Will Hall, Adele Framer, etc.

      My psychiatrist was a person of colour, and I’m Caucasian. I don’t think he was trying to disable me on purpose for population control or whatever other things like that.

      I’m pretty sure all medical professionals want to keep you having a reasonable quality of life so you can work and buy stuff and socialize and have kids if you’re interested.

      At worst, they’re just collecting their paycheque. But I don’t think it’s worse than that. Ironically, a lot of Doctors, Psychiatrists, Neurologists, etc are suffering while on the SSRI’s/Benzos/Anti-Convulsants/Tranquilizers themselves. Or they’re currently in acute or protracted withdrawal. Dr Mark Horowitz says this exact same thing, and I never really realized that before.

      I did, however, recently realize that a lot of Doctors and Psychiatrists have never been on these legal Psychotropics before and have certainly never experienced the acute withdrawal symptoms and protracted withdrawal syndrome, hence the unethical medical-gaslighting. That took my anger away. I had no idea why I assumed they’re consumers of the products they work with. That goes back to my childhood, where I was taught to automatically trust doctors and don’t make a fuss. If they make a mistake, too bad.

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      • I guess my sense is that anyone who was genuinely focused on making their clients’ lives better would notice if their interventions made them worse. Sure they WANT their clients to “get better,” but most seem to not deeply believe that is possible, and view “better” as meaning “less” x or y or z. Reducing one’s depressed feelings is not the same to me as improving quality or life, and even less the same as actually improving their sense of control of their lives. And if evidence came in that my approach didn’t work or was based on false premises, I would chance my approach rather than blaming my clients or insisting I was right regardless of the evidence.

        But incompetent or ill-intended, it doesn’t much matter to the clients. There needs to be a real intent to find the best path. Some exceptional practitioners do have that, and get results. But I find them very much in the minority, especially in the psychiatric industry. The proof is in the pudding. And some really crappy pudding is being handed out!

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  3. What a bizarre piece. I looked at some previous MIA responses circa 2019 to this author exhorting him to use verbs apparently nothing has changed for him. He states his “interest” in iatrogenic damage but nothing about undoing it or how he does that. Empty and hollow more of the same.
    It was nice to see some old posters names Oldhead and Rachel are they still posting ? I haven’t been on this site for a very long time.

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  4. You make some good points that are relevant to my family’s capture, chemical battery, and severe harm by psychiatry. I would break this essay down into sections to more fully develop separate sub-topics.

    Right now there is opportunity to enlarge the understanding of psychiatric travesties AND the changes that most of us need and want via responding to RFK, Jr.’s solicitation for the public to disclose their concerns. Everything has NOT been tried in this battle for human rights and justice. Please put aside the cynicism. There is nothing to lose. Many of you have been great encouragement and source of knowledge to me. I must act and not waste this moment. I have failed too many times. I shall consider myself blessed if I keep going as faithfully as Jacob Marley dragging his chains.

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    • It’s interesting you mention your family.

      I could 100% my Cousin was trying an SSRI/SNRI. I could also tell a co-worker did.

      The partial-insomnia: waking up way too early and ready to start the day and then crashing and going to bed way too early. It’s the exact same story as me since 2012.

      The massive weight-gain was a clue. That doesn’t just happen without an extremely powerful prescription that works like an anti-histamine. That’s not related to hormonal birth control pills/IUD’s either, although when you tamper with your body, it’s plausible to be a cause.

      That happened with me on Cipralex and probably the others and is most-certainly happening with these Seroquels.

      Same with the increased irritation that wasn’t present before starting the Pharmaceutical.

      Same with being spacey.

      Same with being kinda unsure of if they have “depression” or not. Like, holding back because now they have a diagnosis and are taking “medication”.

      When you recognize it, you’ll see it everywhere, and I can’t say a damn thing, because it’s none of my business.

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  5. Thank you for this essay. I read it with interest.
    I took particular interest in the part discussing the need to expand our understanding of the body-mind connection. I am totally into it. I would add to your list the potential issues of nutrients deficiencies, the feminine hormonal cycle and hormonal contraceptive methods that might greatly affect emotional well-being.

    Your argument confirms my suspicion that what we call “the bio-medical approach” to mental health is flawed, not just due to its indifference to social-emotional and societal factors, but also due to its narrow, not-enough-biomedical lenses.

    I would like to add a few points of criticism:
    A) Among other biases, is the extraordinary professional bias towards psychotic symptoms and away from post-traumatic features. This bias is shown frequently in mental healthcare, and not by psychiatrists alone. The literature talks about the “diagnosis gap” of people with “severe mental illness” who often carry PTSD as well, but are rarely diagnosed with it. Watching this diagnosis bias in action, I daresay that more than a gap, we might be facing systemic misdiagnosis of psychosis, depression of people whom their main issue is post-traumaic mechanisms. This misdiagnosis is extremely harmful.

    2) I do not agree that the requirement to undergo therapy helps improve practices. My close observations of a psychodynamic-oriented professional culture, in which psychotherapy students/candidates.professionals were expected to undergo treatment, didn’t reveal such advantage. In fact, it might creates other unpleasant biases.

    I don’t care if psychiatrists undergo therapy themselves. I care very much to see them acquiring good counselling skills during their training, and then being ongoingly prompted to apply them.

    3) What about the MEntal Health Acts? How does it support the moral corruption of doctors, and how should psychiatrists resist it?

    4) Maybe most important is the way in which Psychiatry took a turn away from the ethos and ethics of healthcare provision, and sigled itself out as permitted to treat its patients according to substantially different standards.
    I would iket to invite the readers to read the first paragraph of the article Ethical Principles and Skills in the Care of Mental Illness
    (https://focus.psychiatryonline.org/doi/10.1176/foc.1.4.339)

    Here is a quote:
    “Mental illness influences beliefs, feelings, perceptions, behaviors, and motivations across time. It may interfere with one’s ability to speak, to arrange one’s thoughts, to know one’s preferences… Mental illness ultimately can shape one’s development, personality, and capacities for love, self-knowledge, self-reflection, and societal contribution. It is these qualities that define us as human, as individual, and perhaps as moral agents (1, 2).”

    In other words, the authors suggest that people with “mental illness” are less human than the rest of us, and potentially immoral.
    🙁

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      • But, Steve, you can’t convince a healthy person they are “insane,” if you don’t first start spewing complete insanity at the person, like belief in the “invalid” DSM “BS,” then denying you spewed insanity at the person.

        Oh, but that’s called “gaslighting,” and gaslighting is already known to be “mental abuse,” not “mental health care.”

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    • Thanks for bringing up the body-mind connection.

      Especially in withdrawal, our nervous system will 100% tell us what it can and cannot handle right now in terms of food/drink.

      > I would add to your list the potential issues of … the feminine hormonal cycle and hormonal contraceptive methods that might greatly affect emotional well-being.

      Thank you for bringing this up.

      Norethindrone Acetate (LoLoestrin in Canada) tampered with my limbic system so severely, I was kind of dismissed when I went to the Dr with growing concerns – when none of the other ~7 b/c pills did that were listed on my client file. A pharmacist had to RECENTLY teach me about the 4 different types of Progestin found in these pills – 3 years later. Catholicism never taught us about anti-body autonomy/forced pregnancy (pregnancy-control) methods. I even didn’t know about IUD’s until I was 27. I didn’t know about pap-smears until a group of peers told me at age 25, despite being sexually-active already for a few years.

      An OB/GYN once said that Hormonal IUD’s don’t tamper with your brain chemistry. So, when lots of women were saying that something’s *legitimately* different with their emotions now that the Kyleena/Mirena is in, the client just has emotional problems, and it’s not the IUD. …lolk. The Copper IUD doesn’t seem to directly affect estrogen, although a lot of people say that it completely messes up their menstrual cycle and emotions, too. I guess I got lucky. Because women only have this piece of shit because we don’t want to have a very uncomfortable abortion.

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  8. I completely agree with many commenters who point out that the writer is a psychiatrist themselves, which naturally means they would try to defend their industry. However, instead of focusing on the author, I’ll just add my two cents:

    1. Psychiatry is not medicine. It should be governed under the law because it functions more like a combination of prosecutor, judge, and cop all rolled into one. It has absolutely nothing to do with medicine. Maybe hundreds of years ago, psychiatry had some ties to medicine, like when enslaved people were diagnosed with fabricated conditions for trying to escape. But let’s be real—it’s 2024. Psychiatry is not medicine.

    2. This might sound radical, and maybe my comment won’t even be posted, but it’s worth saying: people need to be empowered not to take psychiatric diagnoses as their identity or even fully believe in them. For instance, if you go to the doctor for a sprained ankle, you don’t carry that diagnosis with you for the rest of your life. Similarly, psychiatric diagnoses should be treated as temporary and situational, not as permanent reflections of your entire person. The language and approach need to shift to reflect this. Psychiatrists don’t know more about you than you do. Their diagnoses should be viewed as temporary observations, not definitive labels.

    If more people stop taking these diagnoses seriously, the industry will eventually collapse under its own irrelevance.

    Just my two cents.

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    • Agreed. Even if you have some bizarre Dx of depression, or Bipolar # whatever, nobody cares. If I was your Employer, I’d say: oh yea. I see. Get back to work and go make me some money.

      If any person in my hobbies were to tell me they had a Dx, I would be completely unphased & most-likely secretly question it but wouldn’t say anything.

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