World Mental Health Day: 'No such things as psychiatrists'

[emad]

'Dope'll get you thru times of no money better than money thru times of no dope'....

London - (Associated Mess): The broadly-ranging term 'psychiatrist' must be abolished as being a delusional term for a wide grouping of symptoms associated with the pharmaceutical industry's outreach workers who have been programmed to implant over-reliance on chemical solutions into the chronically intervention-dependent.

That is the main finding of the World Mental Health Day Forum which meets tomorrow amid growing media concerns that the medical profession has produced a hybrid form that stigmatises people as being violent, dangerous and untreatable.

Their spokesman has noted today that "although the term is scientifically meaningless, it does group together a whole range of different problems under one label", and is proven to encourage the widespread use of drastic biomedical interventions without which the pharmaceutical industry would have gone down the pan a long, long time ago.
http://www.thespoof.com/news/spoof.cfm?headline=s3i11585

[Jackpine Radical]

1. The joke is on the people who think this is a spoof.

But then maybe I'm somewhat prejudiced on the issue.

[oldboy101]

2. Psychiatrists are often the equivalent of witch doctors.

These are the people who once performed frontal lobotomies on helpless people, turning them into vegetables. Also electric shock therapy to fry their brains.

While some of these doctors do help some people, many other patients wind up worse off after psychotherapy and other treatment than they were before. The complexity of the way people think is beyond the abilities of many doctors, so they prescribe some mind altering drug that often does more harm than good.

Our society has come to rely on these doctors often as a subsitute for the advice of clergy, as fewer people practice their religion seriously anymore. So psychiatrists and psychologists are given more status than they deserve. I say so as one who had to endure such sessions for awhile many years ago. There was one guy who I could talk things over with much as with a good friend, but the others were not worth spit.

[varkam]

3. Oy.

These are the people who once performed frontal lobotomies on helpless people, turning them into vegetables. Also electric shock therapy to fry their brains.

There's no denying that there's a sordid history of psychiatry and frontal lobotomies and ECT (electro-convulsive shock therapy). I'm not sure about frontal lobotomies, but I do know that ECT is still used today as a last-ditch treatment for severe depression where at least three conditions have to be met: 1) Both pharmacotherapy and psychotherapy have failed to treat the person, 2) The person is suicidal, 3) Informed consent is obtained (by informed consent, I mean that the person is informed of the possible risks and benefits of ECT and agrees to go through with it). ECT does, however, help people where other treatments have failed. Perhaps the reason that ECT is often singled out as a bogeyman is that, in the past, it was used as a punishment inside of mental health institutions and not as a treatment.

I don't know if traditional frontal lobotomies are still performed, but I do know that psychosurgery is done in much the same fashion as ECT - as a last-ditch effort for treatment. I don't think frontal lobotomies were ever used as punishments, though there was a time when people thought that front-lobotomies were an excellent treatment for psychosis. They were right. The flip side is, of course, that it affected everything else about that person such as cognition, personality, etc.

While some of these doctors do help some people, many other patients wind up worse off after psychotherapy and other treatment than they were before. The complexity of the way people think is beyond the abilities of many doctors, so they prescribe some mind altering drug that often does more harm than good.

Just to be nit-picky, psychiatrists don't often do psychotherapy. Traditional psychotherapy is performed by psychologists and clinical social workers, to name a couple. Psychotherapy is often referred to as "talk therapy" - as that's what is done. Drugs aren't part of psychotherapy. Psychiatrists, so far as I know, do receive some training in psychotherapy but due to managed care, typically perform med checks and prescribe drugs as insurance companies won't cover long-term psychotherapy with psychiatrists (as they can charge more, since they have a MD).

I don't wish to say that all is known about how the brain works and what meds work best for treating such-and-such an illness. There's still a hell of a lot more to learn. However, it's my impression that you have the odds of being helped versus being hurt flip-flopped: pharmacotherapy is to the benefit of more than it is to the detriment - many more. I don't have a dog in the pharmacotherapy fight, but I came to that conclusion just by looking at the evidence. Drugs help a lot of people with a variety of mental illnesses. That's not to say that certain drugs aren't right for certain people, as there certainly are adverse side effects. Of course, any psychiatrist would (hopefully) inform the person of those possible side effects before prescribing a treatment.

Our society has come to rely on these doctors often as a subsitute for the advice of clergy, as fewer people practice their religion seriously anymore. So psychiatrists and psychologists are given more status than they deserve. I say so as one who had to endure such sessions for awhile many years ago. There was one guy who I could talk things over with much as with a good friend, but the others were not worth spit.

Okay. You're joking, right? Clergy are about as qualified to deal with mental illnesses as a florist is to rebuild a carburetor. I'm not saying that there aren't compassionate and well-intentioned clergy out there, as I know that there are. I am saying that asserting that clergy have the training and the tools to deal with bona-fide mental illnesses reflects a woeful misunderstanding of mental illness at best and an open hostility towards the mentally ill at worst.

I'm sorry that you had bad experiences with them in the past. Any of us who have been in and out of therapy have probably had a few who we thought were pretty bad at what they did - I've had a couple myself. I realize, however, that even if I thought that I wasn't benefited by therapists or drugs, that doesn't mean that most people aren't.

[oldboy101]

4. Thank you for your informed reply, Varkam.

Perhaps I went overboard in my comments. I did not find the people I dealt with to be very helpful personally, but I still managed to recover thanks to my own religious experiences and faith. That worked better for me.

However I would not want anything I said to discourage someone else who might in fact benefit from working with such doctors. Good luck to all of us who know what it is like to have to overcome mental problems.

[Warpy]

5. I dealt with lobotomized patients in my first healthcare job

It was a locked ward in a state hospital in the south. Old timers there told me what an enormous difference the phenothiazine drugs like Thorazine had made, that lobotomy was the only way to cope with violent patients before the drugs were developed.

The lobotomized patients were far from vegetables, but they all had very flat affects, with one notable exception. That exception had been lobotomized twice, and had tertiary syphilis as the underlying problem. She was on a permanent happy drunk, although I did see her get blue and cry once, something that lasted all of five minutes. Most patients were just blank. They'd go about their business, show up for meals, and speak when they were spoken to and that's about it. The ones with family support went home and were presumably about the same.

The lobotmy was an incredibly clumsy surgery that destroyed much more brain tissue than should ever have been necessary. The understanding of brain structure was in its infancy, and there was often no alternative to the procedure. It fell out of favor because it was barbaric due to its clumsiness and because chemical treatment had been developed.

The talking therapies do have their place, especially with depression and family therapies. The severe mental illnesses that have a chemical and/or structural basis are better dealt with chemically. Psychosurgery is a last resort and is usually restricted to severe depression that has been resistant to all drugs, ECT and the talking therapies.

The clergy's record of dealing with mental illness is a dismal one, one full of exorcisims, ducking stools, and incarceration with tours for the amusement of the aristocracy.

[varkam]

6. Interesting points.

The talking therapies do have their place, especially with depression and family therapies. The severe mental illnesses that have a chemical and/or structural basis are better dealt with chemically. Psychosurgery is a last resort and is usually restricted to severe depression that has been resistant to all drugs, ECT and the talking therapies.

Which mental illnesses have a chmeical and / or structural basis? Asserting that certain mental illnesses are caused by chemical imbalances in the brain is a bit of a casual fallicy, IMO. For instance, many people say that depression is caused by a chemical imbalance in the brain. It could just as easily be that the depression causes the chemical imbalance, or that there is some other - as yet unnamed factor - influencing them both. Further, there are numerous empirically validated treatments for a psychotherapeutic paradigm which help a variety of different mental illnesses.

The clergy's record of dealing with mental illness is a dismal one, one full of exorcisims, ducking stools, and incarceration with tours for the amusement of the aristocracy.

Amen :evilgrin:

[Ayesha]

8. Chemical/structural basis

I am a psychotherapist intern, and in my Masters program we were taught that schizophrenia is absolutely chemical. It often develops in people with no history of abuse or trauma, and medication is the only effective treatment for the disease itself. Bipolar disorder (manic depression) also has a strong biological and genetic component. Therapy helps with managing symptoms and accepting the disease, but medication is necessary to get the episodes under control.

With all mental illnesses, it is not about therapy vs. medication. BOTH are important! I personally believe that anyone who takes psychotropic medication should see a therapist on a regular basis. Regardless of what brought on the person's illness, they need support and coping skills in order to heal. A pill will not provide that.

[varkam]

9. I agree with you.

However it is also important to note that the etiology of both Schizophrenia and BP1 are not completely genetic. If it were, than the concordance rates between monozygotic twins where one develops the disease would be 100% - but they are far from that. As far as I am aware, the most applicable etiological model for illnesses like these is the diathesis-stress model: people have an inherent predisposition (diathesis) and it gets kicked off by some major life event (stress).

I agree with you with regard to therapy and medications. Efficacy studies tend to show that both are most effective when used in combination with one another. As you said therapy provides a very important function in the treatment of an individual. I used to intern at a mental health clinic, and the generally rule there was that no one got in to see the psychiatrist (i.e. to get meds) without being in individual therapy first. Such rules also discouraged drug-seeking behavior.

[postulater]

7. Nice Pink Freud graphic