As a psychiatrist for the last 45 years—one who has considered himself a subversive agent when he was employed within the system—I can testify that most psychiatrists are so caught up in the trance that they actually believe it. To survive medical school, internship and residency you almost have to become a fact memorizing, authority-trusting, algorithm-following robot. You are then, unless you are incredibly willful, and surrounded by supportive others, you are hired by a huge corporation to be essentially an assembly line worker; moving product through the system. Long hours, perpetually on call; any time for reflection is stolen time. Neoliberalism and the DSM project hit just as I finished my training in the mid-seventies. It’s been going to Hell ever since.