Anyone who’s been reading my blog for very long knows I’m highly critical of many of the practices of mainstream mental health treatment. I feel there is an extremely dangerous power imbalance (treatment providers have nearly unlimited power; consumers have almost none) that frequently does much more harm than good.
But I hope I’ve also conveyed that I’m not categorically opposed to psychiatric treatment.
There’s this prevalent attitude among anti/critical-psychiatry folks that ALL mental health treatment is ALL bad. No one should ever be hospitalized, no one should ever be on medications, no one should ever be in therapy. I think that attitude is just as dangerous as the paternalistic, infantilizing attitudes of mainstream psychiatry. It shames and scares people away from seeking treatment that could be very helpful to them.
In terms of mental health treatment, I believe in choice and informed consent as the guiding principles. When I say “informed consent,” I’m not talking about a doctor’s quick warning that there could be side effects or the drug information sheet they give you at the pharmacy. I mean in-depth discussion about risks and benefit in which the doctor is open about all the possible side effects, the true efficacy of drugs (often barely better than placebo) and other treatments, and a conversation in which the patient’s concerns are truly heard and addressed rather than brushed off.
Consumers should know that most of the studies and clinical studies about the efficacy of drugs are almost all funded, directly or indirectly, by drug companies who make enormous profits from these drugs. Consumers should know that “evidence-based” treatments like CBT and DBT are often touted as the best treatments because insurance companies like their time-limited cheapness better.
And consumers should be allowed to make choices without force or coercion. Treatment should be a collaborative process, not a dictatorial one. Their choices should be respected, and they should not be coerced or threatened into doing what their doctors want. There are tons of studies that show the most therapeutic aspect of any treatment methodology is the relationship between client and treater, and no therapeutic relationship can form without mutual trust and respect.
The point of all of this is: Critical psychiatry folks, please don’t throw the baby out with the bathwater! We have a very important point to make, and it has the potential to make hugely beneficial changes to our mainstream systems of psychiatric treatment. But if we go too far to the extreme, we exclude people whose voices are incredibly important. If we reject everything mainstream mental health treatment has to offer, we make ourselves look like fringe lunatics who might very well be mixing up a batch of Kool-Aid with a special ingredient. Overall, I don’t think that’s who we are, but if that’s who we look and sound like, most people are going to discount our points of view. It’s critical that we don’t allow that to happen.