The Life You Save May Be Your Own

DID, knitting, sci-fi, and strong opinions

Babies and Bathwater: Critical Psychiatry June 25, 2012

Filed under: Uncategorized — weordmyndum @ 4:09 pm
Tags: ,

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.


9 Responses to “Babies and Bathwater: Critical Psychiatry”

  1. brandic32 Says:

    You make some really good points here. It is true that mainstream psychiatry tends to strip clients of any sense of agency and the process in which this is done is both demoralizing and dehumanizing. I experienced much of this when I was in and out of psych hospitals years ago. The system does not favor individual choice and individual health, but rather it favors the ever-powerful drug companies and the doctors who push these drugs for them (and get paid quite well to do it). Sadly it’s about power and money and not genuine care for the individual clients. This definitely needs to change, as you have aptly stated here, and the solution to fixing the system isn’t to throw the system out altogether.

  2. Bourbon Says:

    Absolutely. I think it is far too easy for people to generalise as well. See one thing that is bad for one person and then paint it bad for the remainder of society. I woke up to this recently upon reading a blog from a lady considering ECT. My initial reaction was: good grief have they not banned that yet? That is me throwing the baby out with the bathwater I suppose. For some people, ECT is good and helpful.

    • weordmyndum Says:

      Yeah, there are so many misconceptions about ECT–it’s not all like One Flew Over the Cuckoo’s Nest!

      I had 29 ECT’s, and while the treatment itself was not really effective, my experience of the hospital and all the staff involved was overwhelmingly positive. There were also people there who got majorly positive results from the ECT–and they said this without the docs around, so it wasn’t a publicity stunt or anything. In retrospect, I wish I hadn’t done ECT because it caused a lot of memory problems without resolving my depression, but it wasn’t emotionally traumatic. That’s a whole lot more than I can say about a lot of other “treatment” I’ve received.

      • Bourbon Says:

        Right yeah. Thanks for sharing your experiences with it. What other “treatment” have you received 😦 For what it’s worth that I’m sorry that all those ECT’s were unable to give you the result you desired and needed. Is it your short term memory its affected, or your long term memory? B

      • weordmyndum Says:

        I’ve basically been through every psych med in the PDR, 20+ hospitalizations, residential treatment, eating disorder treatment, DBT, CBT, EMDR, psychoanalysis. About the only treatment I haven’t tried was brain surgery (VNS or DBS).

        I’ve seen both short and long-term memory effects. I lost most of the chronological memories of 5 or 6 years before the ECT. I remember people, I remember feelings, but the event-based memories really took a hit. I still have trouble forming chronological memories. I can recite a poem I memorized in third grade, but I often have trouble remembering what I did 2 or 3 days ago.

        I should say, though, that as someone with a serious dissociative disorder, I’m already more prone to forgetting and losing time. A DID expert I did a consult with said that the ECT probably caused worse memory problems for me because I already had that tendency.

      • Bourbon Says:

        That was what I was thinking – how to pick apart what is ECT related and what is DID related.
        Are you still trying to find a therapy to help?

      • weordmyndum Says:

        Yeah, I’m working on the therapy thing. I’m still not feeling a connection to New Therapist 2.0, but it was so hard to find anyone who took my insurance that I don’t want to repeat the process. However, there’s a chance that New Therapist 1.0 might be coming back to work, which is ideal. She’s two towns over from me, so I have to get a ride or take the bus there, but it’s better because I felt a connection with her.

      • Bourbon Says:

        Ah ha. Sounds like you have a couple of options. I’m hopeful that something will work for you soon enough. You have such great determination to keep trying.

  3. For a lot of my life, I was critical of psychiatry. That kept me from seeking out treatment from any mental health professional until I reached the peak of my big break.

    You mention something I find disappointing about my interactions with some mental health professionals. Many of them seem to brush me off or reluctant to discuss matters in depth with me. This is aggravating because I am an intelligent person and I will be able to understand what they’re telling me. I can make informed decisions. Besides, people have a right to know the full facts about the treatment or medications they’re receiving.

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